Evaluating the Effect of BMIs on Wound Complications After the Surgical Closure of Pressure Injuries

Background/Objectives: Pressure injuries (PIs) are injuries to the skin and underlying tissue localized over a bony prominence. Surgical complications following the closure of a PI include ulcer recurrence, wound dehiscence, hematomas, and infection, which pose significant morbidity issues to patien...

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Main Authors: Stuti P. Garg, Kirtana Sandepudi, Krish V. Shah, Geneviève L. Putnam, Namrata V. Chintalapati, Joshua P. Weissman, Robert D. Galiano
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Surgeries
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Online Access:https://www.mdpi.com/2673-4095/6/1/5
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author Stuti P. Garg
Kirtana Sandepudi
Krish V. Shah
Geneviève L. Putnam
Namrata V. Chintalapati
Joshua P. Weissman
Robert D. Galiano
author_facet Stuti P. Garg
Kirtana Sandepudi
Krish V. Shah
Geneviève L. Putnam
Namrata V. Chintalapati
Joshua P. Weissman
Robert D. Galiano
author_sort Stuti P. Garg
collection DOAJ
description Background/Objectives: Pressure injuries (PIs) are injuries to the skin and underlying tissue localized over a bony prominence. Surgical complications following the closure of a PI include ulcer recurrence, wound dehiscence, hematomas, and infection, which pose significant morbidity issues to patients. The objective of this study is to characterize the relationship between BMI and early and late wound outcomes following surgical closure through a secondary analysis of a previous study examining the effect of two support surfaces on PI healing. Methods: A single institution study on patients with a stage 3/4 pressure injury admitted for surgical closure was conducted. The subjects were monitored for 14 days post-closure (POD-14) so that an assessment of their early wound status and complications, including moisture, maceration, drainage, dehiscence, epidermolysis, necrosis, and demarcation, could be conducted. Results: In total, 68 patients were included. Out of these, 13% of patients were underweight, 29% were normal-weight, 35% were overweight, and 22% were obese. POD-14 complications occurred in 22% of underweight patients, 15% of normal-weight patients, 38% of overweight patients, and 40% of obese patients. 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 <i>P. aeruginosa</i>, <i>S. aureus</i>, and <i>E. coli</i>. Negative cultures were found in 22% of closed wounds and 13% of open wounds. Conclusions: Our findings suggest that BMIs may be correlated with early wound status and the incidence of postoperative complications, while it may not be correlated with osteomyelitis status. Future studies should further evaluate the effect of BMIs on pressure injury-associated complications. This may further guide preoperative planning and patient expectations.
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spelling doaj-art-b5af227d1fee4ca2b1663232f99a63572025-08-20T03:43:57ZengMDPI AGSurgeries2673-40952025-01-0161510.3390/surgeries6010005Evaluating the Effect of BMIs on Wound Complications After the Surgical Closure of Pressure InjuriesStuti P. Garg0Kirtana Sandepudi1Krish V. Shah2Geneviève L. Putnam3Namrata V. Chintalapati4Joshua P. Weissman5Robert D. Galiano6Division of Plastic & Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USADivision of Plastic & Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USADivision of Plastic & Reconstructive Surgery, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USADivision of Plastic & Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USADivision of Plastic & Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USADivision of Plastic & Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USADivision of Plastic & Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USABackground/Objectives: Pressure injuries (PIs) are injuries to the skin and underlying tissue localized over a bony prominence. Surgical complications following the closure of a PI include ulcer recurrence, wound dehiscence, hematomas, and infection, which pose significant morbidity issues to patients. The objective of this study is to characterize the relationship between BMI and early and late wound outcomes following surgical closure through a secondary analysis of a previous study examining the effect of two support surfaces on PI healing. Methods: A single institution study on patients with a stage 3/4 pressure injury admitted for surgical closure was conducted. The subjects were monitored for 14 days post-closure (POD-14) so that an assessment of their early wound status and complications, including moisture, maceration, drainage, dehiscence, epidermolysis, necrosis, and demarcation, could be conducted. Results: In total, 68 patients were included. Out of these, 13% of patients were underweight, 29% were normal-weight, 35% were overweight, and 22% were obese. POD-14 complications occurred in 22% of underweight patients, 15% of normal-weight patients, 38% of overweight patients, and 40% of obese patients. 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 <i>P. aeruginosa</i>, <i>S. aureus</i>, and <i>E. coli</i>. Negative cultures were found in 22% of closed wounds and 13% of open wounds. Conclusions: Our findings suggest that BMIs may be correlated with early wound status and the incidence of postoperative complications, while it may not be correlated with osteomyelitis status. Future studies should further evaluate the effect of BMIs on pressure injury-associated complications. This may further guide preoperative planning and patient expectations.https://www.mdpi.com/2673-4095/6/1/5pressure injurysurgical closurecomplicationsBMIosteomyelitis
spellingShingle Stuti P. Garg
Kirtana Sandepudi
Krish V. Shah
Geneviève L. Putnam
Namrata V. Chintalapati
Joshua P. Weissman
Robert D. Galiano
Evaluating the Effect of BMIs on Wound Complications After the Surgical Closure of Pressure Injuries
Surgeries
pressure injury
surgical closure
complications
BMI
osteomyelitis
title Evaluating the Effect of BMIs on Wound Complications After the Surgical Closure of Pressure Injuries
title_full Evaluating the Effect of BMIs on Wound Complications After the Surgical Closure of Pressure Injuries
title_fullStr Evaluating the Effect of BMIs on Wound Complications After the Surgical Closure of Pressure Injuries
title_full_unstemmed Evaluating the Effect of BMIs on Wound Complications After the Surgical Closure of Pressure Injuries
title_short Evaluating the Effect of BMIs on Wound Complications After the Surgical Closure of Pressure Injuries
title_sort evaluating the effect of bmis on wound complications after the surgical closure of pressure injuries
topic pressure injury
surgical closure
complications
BMI
osteomyelitis
url https://www.mdpi.com/2673-4095/6/1/5
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