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Published on: October 20, 2012
Infant Essential Fatty Acid Status Is Not Associated With Postoperative Wound Complication Severity
Samara L Lewis1, Jeremy J Johnson1, Erynn M Bergner2
1Department of Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Insights
Essential fatty acid deficiency (EFAD) did not predict the severity of postoperative wound complications (POWCs) in neonates. This study found no link between EFAD and wound healing issues in infants after surgery.
Area of Science:
- Neonatal surgery
- Wound healing
- Nutritional deficiencies
Background:
- Neonates are prone to postoperative wound complications (POWCs) due to comorbidities like prematurity and malnutrition.
- Critically ill infants on parenteral nutrition face an increased risk of essential fatty acid deficiency (EFAD).
- EFAD may increase susceptibility to infections and impair wound healing, potentially worsening POWC severity.
Purpose of the Study:
- To investigate the association between essential fatty acid (EFA) status and the severity of POWCs in infants.
- To determine if EFAD is a predictor of wound complications after neonatal gastrointestinal surgery.
Main Methods:
- Retrospective review of infants (<1 year) undergoing gastrointestinal surgery.
- Categorization of POWC severity using the World Union of Wound Healing Society Surgical Wound Grading System.
- Analysis of EFA status and other factors to assess their association with wound severity.
Main Results:
- Fifty infants were included; 50% had no POWC, 30% had Grade 1-2, and 20% had Grade 3-4 complications.
- No statistically significant association was found between EFAD and POWC severity in this cohort.
- EFA status did not emerge as a predictor for POWC severity.
Conclusions:
- Essential fatty acid status does not predict the severity of postoperative wound complications in neonates.
- Current evidence does not support delaying elective surgery to correct EFAD for POWC prevention.
- Further research may be needed to fully understand the role of nutrition in neonatal wound healing.
Background:
Neonates are susceptible to postoperative wound complications (POWCs), as prematurity, hypoxia, steroid use, immunosuppression, and malnutrition are all common comorbidities. Critically ill infants, dependent on parenteral nutrition, are at even further risk of developing essential fatty acid deficiency (EFAD). We hypothesized that POWC severity and EFAD were associated because of increased susceptibility to infections and impaired wound healing seen with EFAD.
Methods:
Institutional review board-approved (OUHSC10554), retrospective review from our academic Level IV Neonatal Intensive Care Unit. Infants aged <1 y who underwent a fascial-compromising gastrointestinal surgery from June 1, 2015, to March 15, 2019, and who had essential fatty acids (EFAs) measured ±2 wk from surgery were included. Three blinded investigators independently categorized POWC using the World Union of Wound Healing Society Surgical Wound Grading System. Infants were categorized into three groups: no POWC, POWC Grades 1 and 2 (superficial tissue nonintegrity), and POWC Grades 3 and 4 (deep tissue nonintegrity and complete dehiscence). EFA status and other possible POWC-associated factors were analyzed to determine any association with wound severity.
Results:
Fifty infants met the inclusion criteria. Half (25/50) had no POWC, 30% (15/50) had Grade 1 or 2, and 20% (10/50) had Grade 3 or 4. We found no association between EFAD and POWC severity.
Conclusions:
In our cohort, EFA status did not predict POWC severity. At this time, we cannot suggest delaying elective surgical procedures to correct EFAD as an approach to preventing POWC.
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