Abstract / Summary
Background/Objectives: Postoperative wound complications remain a clinically important challenge across surgical disciplines, while the contribution of preoperative biological status and the early postoperative systemic response remain incompletely understood. This study aimed to investigate whether routinely available hematological and biochemical biomarkers measured before surgery and during the early postoperative period were associated with postoperative wound complications. Methods: This retrospective single-center study included 58 patients undergoing surgical treatment for peri-ankle fractures, a clinically relevant setting for investigating postoperative wound complications. Demographic characteristics and routine laboratory parameters obtained within 24 h before surgery and during the first 6 postoperative hours were recorded. Patients were classified according to the presence or absence of postoperative WoC. Univariate analyses, Benjamini–Hochberg false-discovery-rate (FDR) adjustment, receiver operating characteristic (ROC) curve analyses, and separate Firth penalized multivariable logistic regression models for preoperative and early postoperative parameters were performed. Results: Postoperative WoC developed in 18 patients (31.0%). In the preoperative analysis, hemoglobin, hematocrit, platelet count, sodium, chloride, and total protein differed significantly between groups. Female sex was also significantly associated with WoC. After FDR adjustment, the preoperative platelet count and total protein remained statistically significant. In the early postoperative period, hemoglobin, hematocrit, lymphocyte count, basophil count, sodium, chloride, creatinine, neutrophil-to-lymphocyte ratio (NLR), and prognostic nutritional index (PNI) differed significantly between groups. After FDR adjustment, sodium, basophil count, chloride, hemoglobin, and NLR remained statistically significant. Preoperative total protein showed the highest discriminatory performance (AUC = 0.886, 95% CI 0.797–0.976), whereas postoperative sodium demonstrated the highest early postoperative performance (AUC = 0.808, 95% CI 0.694–0.923). In the preoperative Firth model, female sex (OR = 7.209, 95% CI 1.189–57.415; p = 0.031) and higher preoperative total protein (OR = 1.399, 95% CI 1.168–1.788; p < 0.001) were associated with WoC. In the early postoperative Firth model, lower serum sodium was associated with postoperative WoC (OR = 0.477, 95% CI 0.241–0.789; p = 0.001). Conclusions: These findings indicate exploratory associations between routinely available biomarkers and postoperative wound complications. Their clinical utility remains to be established in larger prospective studies.