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Wounds in Surgical Patients Who Are Obese

Baugh, Nancy MS, RN, ANP; Zuelzer, Helen MS, NP-C, RN; Meador, Jill BSN, RN; Blankenship, Jolie RN, CWOCN

AJN The American Journal of Nursing: June 2007 - Volume 107 - Issue 6 - p 40–50
doi: 10.1097/01.NAJ.0000271848.07721.24
FEATURE: 3.5 HOURS Continuing Education: Wound Wise

Surgery, whether bariatric or not, puts this population at risk. Review the basics of prevention and care.

Overview The number of surgical patients who are obese in the United States is rising, a trend that's likely to continue. Such patients are at higher risk than nonobese patients are for surgical site infections and other complications such as dehiscence, pressure ulcers, deep tissue injury, and rhabdomyolysis. This article details the factors that can contribute to such complications, including a high number of comorbidities, and offers practical suggestions for preventing them. Nurses should understand that special equipment, precautions, and protocols may be needed at every stage of care, and that obese patients aren't anomalies but rather a part of a growing population with particular needs.

Obesity increases the risk of perioperative complications in the skin and underlying tissue, including infection, dehiscence, pressure ulcers, and deep-tissue injury. Vigilant monitoring can be lifesaving.

Nancy Baugh is an NP in the Department of General Surgery at Virginia Commonwealth University Medical Center, Richmond, where Helen Zuelzer is an NP in the Department of Surgery, Division of Plastic and Reconstructive Surgery; Jill Meador is a bariatric clinical nurse coordinator; and Jolie Blankenship is a certified wound, ostomy, and continence nurse.

Contact author: Nancy Baugh, nancygb@comcast.net.

Wound Wise is coordinated by Lia Van Rijswijk, MSN, RN, CWCN: lialine@aol.com.

The authors of this article have no significant ties, financial or otherwise, to any company that might have an interest in the publication of this educational activity.

© 2007 Lippincott Williams & Wilkins, Inc.