腋臭术后伤口延期愈合的影响因素分析及预测模型构建OA

Objective To analyze the related factors affecting delayed wound healing after axillary osmidrosis surgery and to construct a nomogram prediction model for the risk of delayed wound healing after axillary osmidrosis surgery.Methods A total of 334 patients with axillary osmidrosis who visited our hospital and underwent surgical treatment from April 2023 to April 2025 were prospectively enrolled as research subjects.The included cases were divided into a training cohort and a validation cohort at a ratio of 7:3.Patients in the training cohort were then categorized into a delayed wound healing group(n=32)and a normal healing group(n=202)based on whether delayed wound healing occurred postoperatively.Clinical data including gender,age,and surgical conditions were collected for all patients.Potential risk factors were screened by univariate analysis,and independent risk factors were identified by multivariate Logistic regression.A nomogram prediction model was subsequently constructed.The value of this model was validated using receiver operating characteristic(ROC)curves and calibration curves.Results The proportions of patients with a history of smoking,history of alcohol consumption,and non-use of antimicrobial agents,as well as BMI,were all higher in the delayed healing group than in the normal healing group(P<0.05).No statistically significant differences were observed in age,gender,axillary osmidrosis grading,surgical approach,month of surgery,operative time,or intraoperative blood loss between the two groups(P＞0.05).Linear logistic regression analysis revealed no severe multicollinearity among smoking history,alcohol consumption history,non-use of antimicrobial agents,and BMI,indicating that the model was free from multicollinearity interference.Multivariate Logistic regression analysis demonstrated that high BMI,smoking history,alcohol consumption history,and non-use of antimicrobial agents were all independent risk factors for delayed wound healing after axillary osmidrosis surgery(P<0.05).Based on these four risk factors,a nomogram prediction model for delayed wound healing after axillary osmidrosis surgery was constructed.ROC curve analysis showed that the risk prediction model yielded an AUC of 0.917(95%CI:0.871-0.962)in the training cohort,with a sensitivity of 90.62%and a specificity of 84.65%;in the validation cohort,the AUC was 0.959(95%CI:0.907-1.000),with a sensitivity of 80.00%and a specificity of 88.89%,indicating good discriminative ability.Calibration curve analysis demonstrated that the predicted probability of delayed wound healing after axillary osmidrosis surgery was largely consistent with the actual probability,indicating good calibration.The Hosmer-Lemeshow goodness-of-fit test further confirmed that the fitted probability values were generally consistent with the actual probability values(training cohort:χ2=5.445,P=0.709;validation cohort:χ2=11.894,P=0.156).Conclusion The nomogram prediction model for delayed wound healing after axillary osmidrosis surgery,constructed based on the four influencing factors of BMI,smoking history,alcohol consumption history,and antimicrobial agent use,demonstrates good predictive value.