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Subcutaneous perfusion before and during surgery in obese and nonobese patients
Author(s) -
Kaiser Heiko A.,
Kaiser Dagmar J.,
Krejci Vladimir,
Saager Leif,
Erdoes Gabor,
Hiltebrand Luzius B.
Publication year - 2015
Publication title -
wound repair and regeneration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.847
H-Index - 109
eISSN - 1524-475X
pISSN - 1067-1927
DOI - 10.1111/wrr.12389
Subject(s) - medicine , morbidly obese , anesthesia , oxygen tension , prospective cohort study , intubation , surgical incision , obesity , surgery , hypoxia (environmental) , weight loss , oxygen , chemistry , organic chemistry
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 (P sq O 2 ) 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 P sq O 2 before and during surgery. Seven morbidly obese and seven non‐obese patients were enrolled. At baseline breathing room air, P sq O 2 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 P sq O 2 (obese 16.1 kPa and non‐obese 13.4 kPa; p = 0.001). After induction of anesthesia and endotracheal intubation, P sq O 2 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, P sq O 2 does not decrease appreciably following induction of anesthesia, but decreases markedly (∼33%) after commencement of surgery. Given the theoretical risks associated with low P sq O 2 , future research should investigate how P sq O 2 can be maintained after surgical incision.