(WHS-P22) How Does BMI Affect Effect Pressure Ulcer Complications After Surgical Closure?
Friday, May 17, 2024
7:30 AM – 5:00 PM East Coast USA Time
Background: Pressure ulcers (PU) are injuries to the skin and underlying tissue localized over a bony prominence. Major surgical complications include ulcer recurrence, wound dehiscence, hematomas, and infection which pose significant morbidity to patients. The objective of this study is to characterize the relationship between BMI and early and late wound complications following surgical closure.
Methods: A single institution prospective study was conducted to include patients with a stage III/IV pressure ulcer admitted for surgical closure. The subjects were monitored for 14 days post-closure (POD-14) for assessment of early wound status and complications, including moisture, maceration, drainage, dehiscence, epidermolysis, necrosis, and demarcation.
Results: 68 patients were included. 13% of patients were underweight, 29% normal weight, 35% overweight, and 22% obese. POD-14 complications occurred in 22% of underweight patients, 15% of normal weight, 38% of overweight, and 40% of obese patients. There was a significant difference between POD-14 complication rates across underweight, normal weight, and elevated BMI groups (p=.002). The odds ratio of complication occurrence given an elevated BMI compared to a normal BMI was 4.14 with a relative risk of 3.07. Of all recorded complications, 75% of patients were overweight or obese. Complication rates were not significantly different based on osteomyelitis status. The most common cultures identified in wounds were P. aeruginosa, S. aureus, and E. coli. Negative cultures were found in 22% of closed wounds and 13% of open wounds.
Conclusion: Our findings suggest that BMI may be correlated with early wound status and the incidence of postoperative complications, while osteomyelitis status may not. Future studies should further evaluate the effect of BMI on pressure ulcer associated complications. This may further guide preoperative planning and patient expectations.