Skin and wound care challenges in the hospitalized morbidly obese patient

Hospitalization of the morbidly obese patient is a challenging experience for both the patient and his or her caregivers. Risk of skin breakdown is increased due to immobility caused by underlying disease processes, sedation, improperly sized rooms and equipment, and inadequate staff numbers or staff who lack training in bariatrics. Many of the common and predictable complications related to obesity are more closely related to the nurse's inability to mobilize the patient because of improperly sized rooms and equipment. To complicate matters, wound healing may be impaired by obesity-related underlying disease, such as diminished tissue perfusion. These risks exist in all areas of patient care, including the operating room, emergency department, and nursing units. In this article the demographics, definition, and etiologies of obesity, along with skin breakdown, are described, and the prevention of skin breakdown in hospitalized morbidly obese patients is explored.