JMIR Publications

ABSTRACT

The study systematically reviewed the literature to investigate the risk factors for wound-related complications after primary versus metastatic tumour surgery. Screening of English-language publications between 2013-2023 on primary and metastatic spinal tumours surgery was conducted. The pooled analysis was done, which compared the risk factors identified in the studies for both metastatic and primary spine, which were defined as patient-related factors and surgery-related factors. The search strategy identified 506, but only 20 studies were included after screening through inclusion and exclusion criteria. Out of the 20 studies, 17 studies were retrospective studies, 2 were systematic reviews, and 1 was an RCT study. Wound complications were associated with factors such as BMI, female sex, preoperative chemotherapy, smoking history, preoperative radiation, nutrition status, type of surgery, surgery duration, blood loss, preexisting conditions (like diabetes, hypertension) and medication. Holding these risk factors constant, the wound complications were higher for the metastatic spine than primary spine tumours, indicating that patients with metastatic spine tumours had a higher risk of developing wound complications after surgery than those with primary spine tumours. The risk factors associated with wound complications in metastatic tumours included BMI, blood loss, medication, age, higher blood loss, neurological deterioration after surgery, venous thromboembolism (VTE), smoking, preexisting patient conditions such as diabetes, nutrition status of patients, American Society of Anesthesiologists risk classification (ASA) greater than 2, ambulatory presence, nutrition status of patients and ambulatory presence, history of previous radiation, type of surgery, surgery duration and type of tumour. Risk factors for primary tumours included sacral procedures and the use of equipment when conducting surgery. Given these factors, wound complications were higher for metastatic spine than primary spine tumours.