title: Longer operative time is the risk for delayed wound healing after forefoot surgery in patients with rheumatoid arthritis.
abstract: OBJECTIVE
  Forefoot deformities are common in patients with rheumatoid arthritis (RA) and often require operative treatment. There is a high rate of delayed wound healing after foot surgery, especially among patients with RA. The aim of this study was to identify risk factors of delayed wound healing in RA patients who had undergone forefoot surgery.
  
  
  METHODS
  This study was a retrospective observational study designed to analyze the outcomes of all consecutive RA patients who had undergone toe arthroplasty from April 2010 through May 2014 at a single institute. Putative risk factors for delayed wound healing were assessed using univariate logistic regression analysis. Variables with α = 0.1 were then subjected to stepwise multivariate logistic regression analysis.
  
  
  RESULTS
  A total of 192 RA patients (192 feet) were included in this study. Delayed wound healing was seen in 40 feet (40/192 [20.8%]). A stepwise multivariate logistic regression analysis revealed that longer operative time was the risk factor associated with delayed wound healing in RA patients undergoing forefoot surgery (p = 0.028, odds ratio = 1.19 [per 10 min], 95% confidence interval [CI]: 1.07-1.32).
  
  
  CONCLUSIONS
  This finding emphasizes the importance of preventing operative complications during forefoot surgery.
authors.affiliation: a Institute of Rheumatology, Tokyo Women's Medical University , Shinjuku, Tokyo Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yano
authors.affiliation: a Institute of Rheumatology, Tokyo Women's Medical University , Shinjuku, Tokyo Japan.|b CREST, JST , Shinjuku, Tokyo Japan.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Ikari
authors.affiliation: a Institute of Rheumatology, Tokyo Women's Medical University , Shinjuku, Tokyo Japan.
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Takatsuki
authors.affiliation: a Institute of Rheumatology, Tokyo Women's Medical University , Shinjuku, Tokyo Japan.
authors.forename: Atsuo
authors.initials: A
authors.lastname: Taniguchi
authors.affiliation: a Institute of Rheumatology, Tokyo Women's Medical University , Shinjuku, Tokyo Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Yamanaka
authors.affiliation: a Institute of Rheumatology, Tokyo Women's Medical University , Shinjuku, Tokyo Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Momohara
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000601:surgery*; D005260:Female; D005545:Forefoot, Human / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D019637:Orthopedic Procedures; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014945:Wound Healing / Q000502:physiology*
keywords: Delayed wound healing; Forefoot surgery; Operative time; Rheumatoid arthritis