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Groin Complications Among Obese Patients Undergoing Vascular Procedures.
Randall A Bloch1, Jacob L Neir1, Elisa Caron1
1Division of Vascular and Endovascular Surgery, St. Elizabeth's Medical Center, Boston University School of Medicine, Boston, MA.
Annals of Vascular Surgery
|September 29, 2024
Summary
Obese and female patients experience more groin wound complications after vascular surgery. Avoiding subcuticular closure and ensuring close follow-up can reduce risks, particularly minor complications in obese individuals.
Area of Science:
- Vascular Surgery
- Surgical Site Infections
- Patient Outcomes
Background:
- Groin incision wound complications (WC) are frequent in vascular surgery patients.
- Obesity is a known risk factor for WC, yet prevention strategies lack consensus.
- This study aimed to identify WC risk factors and prevention methods in obese patients.
Purpose of the Study:
- Identify specific risk factors for groin wound complications in obese vascular surgery patients.
- Evaluate strategies to prevent wound complications in this high-risk group.
- Differentiate between major and minor wound complications.
Main Methods:
- Retrospective review of 238 longitudinal groin incisions (2021-2022).
- Patients stratified into obese (BMI > 30 kg/m²) and nonobese cohorts.
- Wound complications classified as major (requiring reoperation/readmission) or minor.
Main Results:
- Obesity significantly increased WC rates (39.1% vs. 14.1%, P < 0.001), mainly minor complications.
- Female sex was also associated with higher WC rates (27.6% vs. 12.8%, P = 0.016).
- Among obese patients, subcuticular closure correlated with more minor WC (OR 8.454, P = 0.044).
Conclusions:
- Obesity and female sex are significant risk factors for groin wound complications.
- Subcuticular skin closure may increase minor WC risk in obese patients.
- Intensified postoperative follow-up (rehab, home care, frequent checks) can prevent minor WC escalation.
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