Obesity in general elective surgery

Pravinkumar, Egbert

doi:10.1016/s0140-6736(03)14126-8

Cited by 4 publications

(3 citation statements)

References 2 publications

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“…On the other hand, it was reported that people without surgery-treatment have a significantly shorter survival time than surgical patients [ 31 , 46 , 47 ] indicating that surgery is a great factor for RCC postoperative survival. Obesity contributes to poor postoperative complications especially wound infection [ 48 – 53 ]. Yet, overweight and obesity might provide more sufficient nutritional reserve and metabolic state to overcome the stress of surgery.…”

Section: Discussionmentioning

confidence: 99%

Association of body mass index with mortality and postoperative survival in renal cell cancer patients, a meta-analysis

Zhang

Chen

et al. 2018

Oncotarget

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Obesity is one of the major risk factors of cancer. However, how body mass index (BMI) influences the prognosis of renal cell cancer (RCC) patient is unclear. In this work, we have performed a meta-analysis to elucidate the role of abnormal weight in RCC mortality and postoperative survival. Articles related to BMI and RCC mortality as well as postoperative survival has been identified by searching PUBMED and ENBASE. Totally, 19 articles have been selected for this meta-analysis, 5 articles for RCC mortality and 14 for postoperative survival. Compared to normal weight, the estimated relative risks of RCC mortality are 0.71 (95% CI: 0.34–1.49), 1.19 (95% CI: 1.05–1.35) and 1.71 (95% CI: 1.27–2.00) respectively for the underweight, overweight and obesity patients. The risk of RCC mortality increase 5% for each 1 kg/m2 increment of BMI. However, the estimated hazard ratios of cancer specific postoperative survival are 2.62 (95% CI: 1.67–4.11), 0.72 (95% CI: 0.63–0.83) and 0.66 (95% CI: 0.49–0.89) respectively for underweight, overweight and obesity RCC patients. The risk of hazard ratio decrease 5% for each 1 kg/m2 increment of BMI. In addition, the hazard ratios of postoperative overall survival show a similar tendency. These results indicate an opposite association of BMI with mortality and postoperative survival in renal cell cancer patients.

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Section: Discussionmentioning

confidence: 99%

Association of body mass index with mortality and postoperative survival in renal cell cancer patients, a meta-analysis

Zhang

Chen

et al. 2018

Oncotarget

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“…It may lead to a systemic inflammatory state that increases the risk of postoperative complications including SSI. Pravinkumar et al [ 26 ] reported an increased incidence of superficial wound infection in obese patients who opted for general surgery. In addition, Spaine et al [ 27 ] reported that higher BMI was also associated with increased injury severity, which may also lead to an increased incidence of SSI.…”

Section: Discussionmentioning

confidence: 99%

Development of a nomogram to predict surgical site infection after open reduction and internal fixation for closed pilon fracture: a prospective single-center study

Xie

Wang

et al. 2023

J Orthop Surg Res

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Background To explore the risk factors and develop a nomogram in order to predict surgical site infection (SSI) after open reduction and internal fixation (ORIF) for closed pilon fractures (CPF). Methods A prospective cohort study with one-year follow-up was carried out in a provincial trauma center. From January 2019 to January 2021, 417 adult patients with CPFs receiving ORIF were enrolled. A Whitney U test or t test, Pearson chi-square test, and multiple logistic regression analyses were gradually used for screening the adjusted factors of SSI. A nomogram model was built to predict the risk of SSI, and the concordance index (C-index), the receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA) were used for evaluating the prediction performance and consistency of the nomogram model. The bootstrap method was employed to test the validity of the nomogram. Results The incidence of SSI after ORIF for CPFs was 7.2% (30/417): 4.1% (17/417) of superficial SSIs and 3.1% (13/417) of deep SSIs. The most common pathogenic bacteria were Staphylococcus aureus (36.6%, 11/30). The multivariate analysis showed tourniquet use, longer preoperative stay, lower preoperative albumin (ALB), higher preoperative body mass index (BMI) and hypersensitive C-reactive protein (Hs-CRP) were independent risk factors of SSI. Additionally, the C-index and bootstrap value of the nomogram model were 0.838 and 0.820, respectively. Finally, the calibration curve indicated that the actual diagnosed SSI had good consistency with the predicted probability, and the DCA showed that the nomogram had clinical value. Conclusions Tourniquet use, longer preoperative stay, lower preoperative ALB, higher preoperative BMI and Hs-CRP were five independent risk factors of SSI after closed pilon fractures treated by ORIF. These five predictors are shown on the nomogram, with which we may be able to further prevent the CPS patients from SSI. Trial registration NO 2018-026-1, October /24/2018, prospectively registered. The study was registered in October 24, 2018. The study protocol was designed based on the Declaration of Helsinki and admitted by the Institutional Review Board. The ethics committee approved the study on factors related to fracture healing in orthopedic surgery. Data analyzed in the present study were acquired from the patients who underwent open reduction and internal fixation from January 2019 to January 2021.

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“…Surgical site infection (SSI) is a postoperative complication and an important part of nosocomial infection [ 2 ]. Factors affecting postoperative wound infection include operating room, type and duration of surgery [ 3 , 4 ], surgical personnel, physiological states of patient [ 4 , 5 ], and antimicrobial drug use [ 6 ]. Given that antibiotics are the most widely used antimicrobial agents, the rational use of this medicine is the key to prevent incision infection in surgical operations [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Application of antimicrobial drugs in perioperative surgical incision

Xiao

Wang

et al. 2018

Ann Clin Microbiol Antimicrob

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Infection in surgical incision often results in poor wound healing, and one of the main factors for wound infection is the use of antimicrobial agents. Rational use of antibiotics is one of the key factors to prevent incision infection in general surgery. The number of current clinical studies on antibiotic use before and during surgery is greater than that of systematic studies on antibiotic use after surgery. For the rational use of antibiotics and improvement of wound healing rate, researchers around the world have gradually focused on the use of antibiotics after surgery. Despite the familiarity on the concept of “rational use of antibiotics”, few clear and systematic studies were conducted to elucidate the effect of different antibiotics on wound healing. Therefore, this review focuses on the use of different types of antimicrobial agents in surgical wounds.

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Obesity in general elective surgery

Cited by 4 publications

References 2 publications

Association of body mass index with mortality and postoperative survival in renal cell cancer patients, a meta-analysis

Association of body mass index with mortality and postoperative survival in renal cell cancer patients, a meta-analysis

Development of a nomogram to predict surgical site infection after open reduction and internal fixation for closed pilon fracture: a prospective single-center study

Application of antimicrobial drugs in perioperative surgical incision

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