Effect of sleep quality on wound healing among patients undergoing emergency laparotomy: an observational study.

Abstract

Study objectives: We aimed to study the association between sleep quality, total sleep duration, and wound healing among adult patients who had good sleep quality at the time of admission to the hospital who underwent laparotomy for various reasons.

Methods: In this observational study, consecutive adult patients undergoing emergency laparotomy were followed up until the eighth postoperative day. The primary outcome (wound healing) was assessed using the Southampton Wound Grading System. Sleep quality (assessed by the single-item sleep quality scale) was the primary predictor. Pain was assessed using a visual analog pain scale. We studied the effect of postoperative sleep quality on wound healing on postoperative day 8. Secondary analyses assessed the effect of total sleep time, severity of pain, and markers of systemic inflammation on wound healing.

Results: In this study 110 participants were included. The average age of participants was 41.7 ± 16.2 years. On postoperative day 8, 34.5% rated their sleep quality as "poor to fair" and the rest as "good." Postoperative poor sleep quality was associated with impaired wound healing, starting from the third postoperative day (P < .001 for each subsequent day). Multiple logistic regression was overall significant (χ² = 118.40; degrees of freedom = 9; P < .001), classified 92.7% cases correctly, and explained 88% variance to the outcome. This model showed that shorter total sleep time (P = .009), higher total leukocyte count (P = .005), presence of comorbidities (P = .01), and poor sleep quality during the postoperative week (odds ratio = 78.14; P = .005) increased the odds for impaired healing of wounds.

Conclusions: Poor sleep quality during the healing phase is associated with wound complications, a surrogate marker of impaired wound healing.

Citation: Das A, Gupta R, Huda F, Kumar N, Krishnan V, Basu S. Effect of sleep quality on wound healing among patients undergoing emergency laparotomy: an observational study. J Clin Sleep Med. 2025;21(3):503-512.