Associations between GLP 1 receptor agonist therapy and surgical wound healing in a high-risk cohort

Objective: This pilot, signal-detecting cohort study examines associations between systemic GLP-1 receptor agonist (GLP-1RA) use and surgical wound healing outcomes in high-risk surgical populations, including patients with diabetes. Approach: This pilot retrospective cohort study compared adult surgery patients with non-healing postoperative wounds by their preoperative GLP-1RA use. We identified cases using standardized administrative coding and assessed wound healing outcomes through structured review of clinical notes. Outcomes included healing status, time to wound closure, and number of surgical interventions. Results: The cohort included 35 non-GLP-1RA users and 16 GLP-1RA users with comparable baseline characteristics, except for significantly higher prevalence of venous insufficiency among users. Though median time to closure was similar for all patients, users required fewer surgical interventions and wound closure rates were significantly higher than in non-users. Among patients with diabetes, all GLP-1RA users healed significantly compared to non-users. Innovation: The impact of GLP-1RA therapy on wound healing in high-risk patients remains poorly defined. This pilot cohort of surgical patients addresses that gap, offering an early signal that preoperative GLP-1RA use is associated with improved wound healing and fewer postoperative interventions. These findings may inform perioperative practice by identifying a systemic pharmacologic factor associated with improved surgical outcomes in high-risk populations. Conclusion: In this pilot cohort, GLP-1RA use was associated with higher unadjusted healing rates and fewer interventions, particularly among patients with diabetes. Adjusted estimates were directionally consistent but imprecise. These hypothesis-generating findings warrant prospective evaluation in larger multi-site studies before informing perioperative management.