Articles Vol. 67 No. 10 31/10/2026

ASSOCIATION BETWEEN PREOPERATIVE NUTRITIONAL STATUS AND WOUND HEALING OUTCOMES IN MARJOLIN'S ULCER PATIENTS UNDERGOING WIDE EXCISION AND SKIN GRAFTING

Tong Duc Minh, Nguyen Thi Nhung, Le Minh Phong, Nguyen Hoang Trung
DOI: 10.52163/yhc.v67i10.6918
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Abstract

Objective: To analyze the association between preoperative nutritional status and wound healing outcomes and postoperative complications in Marjolin's ulcer patients undergoing wide excision and skin grafting.

Subjects and methods: A descreptive cohort study with 30-day follow-up was conducted on 32 Marjolin's ulcer patients undergoing wide excision and split-thickness skin grafting at the National Burn Hospital and Military Hospital 175 (January 2022 – December 2025). Preoperative nutrition was assessed using NRS-2002, GLIM criteria, and multi-frequency bioelectrical impedance analysis.

Results: Malnutrition by GLIM was present in 40.6%. Graft survival on day 7 was 90.1% overall, lower in malnourished patients (84.2% vs 94.1%; p = 0.013). Complete healing within 30 days was 87.5%; at least one wound complication occurred in 34.4%. Malnourished patients had higher rates of delayed healing (53.8% vs 10.5%; p = 0.015), longer healing time (27 vs 18 days; p = 0.002), and longer time to radiotherapy (p = 0.018). GLIM malnutrition (OR = 8.53; p = 0.021), albumin < 35 g/L, and local infection (both OR = 7.44; p = 0.020) were significantly associated with wound complications.

Conclusion: Preoperative malnutrition is associated with poorer wound healing and increased complications after wide excision and skin grafting in Marjolin's ulcer patients. Preoperative nutritional assessment and optimization are warranted.

Keywords
Marjolin's ulcer, preoperative nutrition, wound healing, skin grafting, complications, GLIM.
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