Construction of a risk prediction model for postoperative wound healing quality of perianal abscess based on Chinese medicine factors

ObjectiveTo investigate the risk factors of poor wound healing after perianal abscess surgery, and construct a nomogram model of poor wound healing after perianal abscess surgery.

MethodsThree hundred patients with perianal abscess were selected as the study subjects.The single factor analysis was used to preliminarily screen the influencing factors of poor wound healing, the lasso analysis was used to screen the predictive factors of poor wound healing, and the logistic regression analysis was used to screen the risk factors of poor wound healing after perianal abscess surgery.The nomograph model of poor wound healing after perianal abscess surgery was established.

ResultsAmong 300 patients with perianal abscess, the poor wound healing in 71 patients after surgery were found.The incidence rate of poor wound healing was 23.67%(71/300).There was no statistical significances in the age, sex, residence, education level, alcohol consumption, operation method, surgical incision, operation time, average daily sitting bath time, recovery time of normal activities, hyperlipidemia, hypertension, heat poison accumulation type and fire poison incandescent type(P>0.05), but there were statistically significant in smoking, poor wound drainage, diabetes, body mass index (BMI), postoperative constipation, postoperative infection, and Yin-deficiency and poison love type between poor healing group and good healing group (P<0.01).The results of lasso regression analysis showed that the smoking, poor wound drainage, diabetes, BMI, postoperative constipation, postoperative infection and TCM syndrome types were the predictors of non-zero coefficients.The results of logistic regression analysis showed that the smoking, poor wound drainage, diabetes, BMI less than 18.5 kg/m², postoperative constipation, postoperative infection and perianal abscess of Yin-deficiency and toxin love type were the risk factors of poor wound healing after perianal abscess surgery (P<0.05 to P<0.01).The results of the nomograph model show that the model consistency index was 0.746 (95%CI: 0.711-0.781).The fitting degree between the correction curve and ideal curve was good.The area under the reciever operating characteristic curve was 0.728, the sensitivity was 81.25%, and the specificity was 79.83%.When the decision curve showed that the threshold probability was within the range of 10%-81%, the nomograph had a higher net benefit value in predicting the poor wound healing after perianal abscess surgery.

ConclusionsThe nomogram model can effectively predict the occurrence of poor wound healing after perianal abscess surgery, and can play a positive role in screening high-risk patients with poor wound healing and formulating relevant prevention and treatment measures.