Incidence and severity of surgical wound complications in diabetic vs non-diabetic patients

Abstract

Background: Surgical wound complications are a common cause of postoperative morbidity, with diabetes mellitus recognized as a key risk factor. Objective: This study aimed to compare the incidence and severity of surgical wound complications in diabetic versus non-diabetic patients. Methods: This comparative cross-sectional study was conducted at Shaikh Zayed Hospital, Lahore from January 2025 to June 2025 . A total of 355 surgical patients were enrolled, including 178 diabetics and 177 non-diabetics. Data on patient demographics, type of surgery, wound complications, and glycemic control (HbA1c) were collected. Postoperative wound assessments were performed on Day 3, Day 7, and Day 14 using CDC criteria and the ASEPSIS scoring system. Results: Surgical wound complications were significantly more frequent in diabetic patients (36.5%) compared to non-diabetics (18.1%) (p < 0.001). Diabetics exhibited higher rates of deep surgical site infections (6.7% vs. 2.3%, p = 0.02), wound necrosis (3.4% vs. 0%, p = 0.01), and required more wound re-suturing or debridement (8.4% vs. 2.3%, p = 0.01). Moderate to severe complications (ASEPSIS score >20) were more common in the diabetic group (22.4% vs. 9.6%, p < 0.01). Patients with HbA1c ≥9% had the highest complication rate (61.3%) among diabetics. Diabetic patients also had a longer mean hospital stay (9.2 ± 3.7 vs. 6.4 ± 2.9 days, p < 0.001) and higher 30-day readmission rates (11.2% vs. 4.5%). Conclusion: It is concluded that diabetes mellitus significantly increases the risk and severity of surgical wound complications, particularly in patients with poor glycemic control. Preoperative optimization of blood glucose, individualized postoperative wound care, and extended follow-up are essential to improve surgical outcomes in this vulnerable group