To investigate the risk factors of postoperative poor incision healing in children with congenital pectus excavatum who underwent thoracoscopic-assisted Nuss procedure.

In this study, a retrospective cohort study method was adopted to statistically analyze the clinical data of children with congenital pectus excavatum who underwent thoracoscopic-assisted Nuss procedure from 2017 to 2024. The children were categorized into groups with good incision healing and groups with poor healing according to the criteria, and the risk factors that might affect the incision healing were collected, including gender, age, height, weight, BMI, HI, type of pectus excavatum, and previous allergy history, number of the Nuss bars, whether fixation piece was applied, fixation method, suture method, surgical time and bleeding amount.

Based on the inclusion and exclusion criteria, a total of 272 children with Nuss procedure were collected, and during the follow-up period, 25 children experienced poor incision healing. Univariate and multivariate logistic regression analyses were performed in both groups, and the results showed that low BMI, asymmetric pectus excavatum, previous allergy history, wire-fixed bars, and intradermal sutures were independent risk factors for poor incisional healing after the Nuss procedure for pectus excavatum (all P < 0.05).

Poor postoperative incision healing is more likely to occur in children with low BMI, asymmetric pectus excavatum, previous allergy history, and children with intraoperative wire fixation of bars and intradermal sutures.