Obesity: impediment to postsurgical wound healing.

PURPOSE To provide physicians and nurses with an overview of the impact of obesity on postoperative wound healing and how preplanning protocols can minimize skin and wound care problems in this patient population. TARGET AUDIENCE This continuing education activity is intended for physicians and nurses with an interest in reducing skin and wound care problems in their patients who are obese. OBJECTIVES After reading the article and taking the test, the participant will be able to: 1. Identify obesity-related changes in body systems and how these impede wound healing. 2. Identify complications of postoperative wound healing in obese patients and the assessments and intervention strategies that can reduce these complications. 3. Identify skin and wound care considerations for obese patients and the role of preplanning protocols in avoiding problems.

[1]  S. Gallagher,et al.  Care of an obese patient with a pressure ulcer. , 2001, Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society.

[2]  P. Benotti,et al.  Wound closure technique and acute wound complications in gastric surgery for morbid obesity: a prospective randomized trial. , 2000, Journal of the American College of Surgeons.

[3]  B. Raynor,et al.  Postoperative morbidity in the morbidly obese parturient woman: supraumbilical and low transverse abdominal approaches. , 2000, American journal of obstetrics and gynecology.

[4]  Michael J. Miller,et al.  Effect of Obesity on Flap and Donor‐Site Complications in Free Transverse Rectus Abdominis Myocutaneous Flap Breast Reconstruction , 2000, Plastic and reconstructive surgery.

[5]  M G Kemp,et al.  Predicting the risk of pressure ulcers in critically ill patients. , 1999, American journal of critical care : an official publication, American Association of Critical-Care Nurses.

[6]  P. Lotke,et al.  Total Knee Arthroplasty in Morbidly Obese Patients* , 1998, The Journal of bone and joint surgery. American volume.

[7]  M. Majewski,et al.  Make a difference: standardize your heel care practice. , 1998, Ostomy/wound management.

[8]  M. Armstrong Obesity as an intrinsic factor affecting wound healing. , 1998, Journal of wound care.

[9]  W. Cohn,et al.  Cutaneous closure after cardiac operations: a controlled, randomized, prospective comparison of intradermal versus staple closures. , 1997, Annals of surgery.

[10]  T. K. Hunt,et al.  Wound tissue oxygen tension predicts the risk of wound infection in surgical patients. , 1997, Archives of surgery.

[11]  L. Israelsson,et al.  Overweight and healing of midline incisions: the importance of suture technique. , 1997, The European journal of surgery = Acta chirurgica.

[12]  M. Carvalho,et al.  Pressure ulcer risk factors in an ICU population. , 1995, American journal of critical care : an official publication, American Association of Critical-Care Nurses.

[13]  Jacob Tm Obesity and the surgical patient: nursing alert. , 1994 .

[14]  W. Eaglstein,et al.  The "trap" hypothesis of venous ulceration , 1993, The Lancet.

[15]  JoAnn Maklebust,et al.  Pressure Ulcers: Guidelines for Prevention and Nursing Management , 1991 .

[16]  T. K. Hunt,et al.  Direct measurement of wound and tissue oxygen tension in postoperative patients. , 1983, Annals of surgery.

[17]  D. Groszek Promoting wound healing in the obese patient. , 1982, AORN journal.

[18]  E. Mason,et al.  Acute postoperative wound complications after gastric surgery for morbid obesity. , 1975, The American surgeon.

[19]  Janet M. Davis,et al.  Persistent leg ulcers in an obese patient with venous insufficiency and elephantiasis. , 2002, Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society.

[20]  T. Jacobson Obesity and the surgical patient: nursing alert. , 1994, Ostomy/wound management.

[21]  R. Bryant Acute and chronic wounds : nursing management , 1992 .

[22]  N. Bergstrom,et al.  The Braden Scale for predicting pressure sore risk. Nursing Research, 36 (4), 205-210 , 1988 .