Surgical wound complications in ankle ORIF patients: a predictive analysis on a single-center retrospective cohort of 287 patients

Purpose: To analyse predictors of surgical wound complications (infection, dehiscence and necrosis) in ankle trauma surgery on a single-center retrospective cohort, to define proper strategies for prevention of surgical wound complications. Methods: Data from 287 adult patients treated with open reduction internal fixation between July 2020 and December 2024 for closed fractures were analysed. The predictive score by Wise et al., incorporating factors such as male sex, body mass index (BMI) ≥ 30, diabetes, alcohol abuse, fracture type, Methicillin Resistant Staphylococcus Aureus (MRSA) nasal colonization, and American Society of Anesthesiology (ASA) class, was retrospectively applied. In addition to the variables considered in the original score, operative time and trauma energy were also analyzed. Results: Male sex (p = 0.018), high-energy trauma (p = 0.005), intraoperative time (p < 0.001), and the Wise et al. wound complication score (p = 0.001) were significantly associated with an increased risk of wound healing complications. However, in logistic regression analysis, male sex was not an independent risk factor. In contrast, the Wise score remained significantly associated with complications (p = 0.021; OR = 1.341; AUC = 0.641). Intraoperative time (p < 0.001; OR = 1.024) and high-energy trauma (p = 0.048; OR = 2.123) were also confirmed as independent predictors. Conclusion: The findings suggest the model may help identify high-risk patients, though further validation is needed.