Obesity Increases Risk for Wound Complications After Pediatric Foot Surgery: A Retrospective Cohort Review Using the...

Area of Science:

• Pediatric Orthopaedics
• Surgical Outcomes Research
• Obesity Medicine

Background:

• Childhood obesity is a growing public health concern.
• Increasing rates of obesity in children lead to more frequent foot surgeries.
• Understanding obesity-related risks is crucial for patient safety in pediatric foot surgery.

Purpose of the Study:

• To retrospectively analyze the association between obesity and postoperative outcomes in pediatric foot surgery.
• To evaluate risks in obese versus normal-weight children undergoing foot surgery.
• To utilize a large national database for comprehensive analysis.

Main Methods:

• Retrospective review of the American College of Surgeons 2012-2017 Pediatric National Surgical Quality Improvement (ACS-NSQIP-Pediatric) database.
• Identification of pediatric foot surgery patients using CPT and ICD-9/ICD-10 codes.
• Stratification into normal-weight and obese cohorts using CDC BMI-to-age growth charts; univariate and multivariate analyses performed.

Main Results:

• Obese patients (27.1%) had higher rates of overall postoperative complications (3.01% vs. 1.32%) and wound dehiscence (1.41% vs. 0.59%).
• Obesity was an independent predictor of wound dehiscence (OR=2.16) and surgical site infection (OR=3.03).
• In clubfoot capsular release subgroup, obesity independently predicted dehiscence (OR=5.71); no differences found for other procedures.

Conclusions:

• Obese children experience increased overall complications, wound complications, and surgical site infections after foot surgery.
• Findings are valuable for risk assessment and discussion with patients and families.
• The rising incidence of childhood obesity necessitates awareness of these surgical risks.