Surgical wound dehiscence following cutaneous excisions: A retrospective study and review of the literature

• Published in: Journal of dermatology & dermatologic surgery 2020-07, Vol.24 (2), p.93-98
• Main Authors: Seyffert, Jennifer, Harding, Tanner, Sanghvi, Asmi, Bibliowicz, Nathan, Yungmann, Martin, Camner, Shawn, Leavitt, Matthew, Solomon, James
• Format: Article
• Language: English
• Subjects: adverse event; cutaneous surgery; dehiscence; dermatologic surgery; postoperative adverse event; postoperative complication; surgical complication; surgical wound dehiscence; wound healing
• ISSN: 2352-2410; 2352-2429
• DOI: 10.4103/jdds.jdds_71_20

Background: Surgical wound dehiscence (SWD) is the third most common adverse event following dermatologic surgery. There have been no previous studies investigating risk factors for SWD following dermatologic surgery. There are no formal recommendations or standards of care to minimize or prevent SWD following dermatologic surgery. Purpose: The purpose of this study was to identify risk factors associated with dermatologic SWD. Methods: Multicenter retrospective data mined from EMA electronic medical record were collected from 22,548 matched excisions and postoperative visits performed on patients ≥18 years between January 1, 2019, and September 27, 2019. Matched data analysis was performed using IBM SPSS Statistics 25 to elucidate factors associated with SWD. Results: The prevalence of SWD was calculated to be 0.55%. A wound reported as positive for presumed infection or postoperative bleeding had 14.48 and 20.15 times the odds, respectively, of also being positive for SWD. A wound located on distal extremities (arm, hand, and lower leg) had 1.86 times the odds of being positive for SWD. Increasing age was found to be statistically significant. Wounds on individuals 80 years of age or greater had 1.7064 times the odds of being positive for SWD. Data did not support a correlation between SWD and sex, SWD and diabetes, or SWD and provider type. Conclusion: Factors that contribute to SWD dehiscence include presence of presumed infection, presence of bleeding, age >80, and location on the distal extremity. Data did not support a correlation between SWD and sex, SWD and diabetes, or SWD and provider type. Dermatologic surgeon identification and reduction of risk factors contributing to this adverse event may prevent SWD.