Subcutaneous perfusion before and during surgery in obese and non-obese patients.

Kaiser, Heiko Andreas; Kaiser Niedhart, Dagmar Julika; Krejci, Vladimir; Saager, Leif; Erdös, Gabor; Hiltebrand, Luzius B (2015). Subcutaneous perfusion before and during surgery in obese and non-obese patients. Wound repair and regeneration, 24(1), pp. 175-180. Wiley-Blackwell 10.1111/wrr.12389

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Hypoxia at the surgical site impairs wound healing and oxidative killing of microbes. Surgical site infections are more common in obese patients. We hypothesized that subcutaneous oxygen tension (Psq O2 ) would decrease substantially in both obese and non-obese patients following induction of anesthesia and after surgical incision. We performed a prospective observational study that enrolled obese and non-obese surgical patients and measured serial Psq O2 before and during surgery. Seven morbidly obese and seven non-obese patients were enrolled. At baseline breathing room air, Psq O2 values were not significantly different (p=0.66) between obese (6.8 kPa) and non-obese (6.5 kPa) patients. The targeted arterial oxygen tension (40 kPa) was successfully achieved in both groups with an expected significant increase in Psq O2 (obese 16.1 kPa and non-obese 13.4 kPa; p=0.001). After induction of anesthesia and endotracheal intubation, Psq O2 did not change significantly in either cohort in comparison to levels right before induction (obese 15.5, non-obese 13.5 kPa; p=0.95), but decreased significantly during surgery (obese 10.1, non-obese 9.3 kPa; p=0.01). In both morbidly obese and non-obese patients, Psq O2 does not decrease appreciably following induction of anesthesia, but decreases markedly (∼33%) after commencement of surgery. Given the theoretical risks associated with low Psq O2 , future research should investigate how Psq O2 can be maintained after surgical incision. This article is protected by copyright. All rights reserved.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy

UniBE Contributor:

Kaiser, Heiko Andreas; Kaiser Niedhart, Dagmar Julika; Krejci, Vladimir and Erdös, Gabor

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1067-1927

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Jeannie Wurz

Date Deposited:

05 Feb 2016 13:46

Last Modified:

23 Jan 2018 12:14

Publisher DOI:

10.1111/wrr.12389

PubMed ID:

26610062

Uncontrolled Keywords:

Subcutaneous tissue; abdominal surgery; general anesthesia; surgical wound infection

BORIS DOI:

10.7892/boris.76624

URI:

https://boris.unibe.ch/id/eprint/76624

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