Pierpont Yvonne N, Dinh Trish Phuong, Salas R Emerick, Johnson Erika L, Wright Terry G, Robson Martin C, Payne Wyatt G
Institute for Tissue Regeneration, Repair & Rehabilitation, Bay Pines VA Health Care System, Bay Pines, FL 33744, USA ; Division of Plastic Surgery, University of South Florida, Tampa, FL 33620, USA.
Division of Plastic Surgery, University of South Florida, Tampa, FL 33620, USA.
ISRN Obes. 2014 Feb 20;2014:638936. doi: 10.1155/2014/638936. eCollection 2014.
Objective. The correlation between obesity and deficient wound healing has long been established. This review examines the current literature on the mechanisms involved in obesity-related perioperative morbidity. Methods. A literature search was performed using Medline, PubMed, Cochrane Library, and Internet searches. Keywords used include obesity, wound healing, adipose healing, and bariatric and surgical complications. Results. Substantial evidence exists demonstrating that obesity is associated with a number of postoperative complications. Specifically in relation to wound healing, explanations include inherent anatomic features of adipose tissue, vascular insufficiencies, cellular and composition modifications, oxidative stress, alterations in immune mediators, and nutritional deficiencies. Most recently, advances made in the field of gene array have allowed researchers to determine a few plausible alterations and deficiencies in obese individuals that contribute to their increased risk of morbidity and mortality, especially wound complications. Conclusion. While the literature discusses how obesity may negatively affect health on various of medical fronts, there is yet to be a comprehensive study detailing all the mechanisms involved in obesity-related morbidities in their entirety. Improved knowledge and understanding of obesity-induced physiological, cellular, molecular, and chemical changes will facilitate better assessments of surgical risks and outcomes and create efficient treatment protocols for improved patient care of the obese patient population.
目的。肥胖与伤口愈合不良之间的关联早已确立。本综述探讨了当前有关肥胖相关围手术期发病率所涉及机制的文献。方法。使用医学在线数据库（Medline）、医学期刊数据库（PubMed）、考克兰图书馆以及互联网搜索进行文献检索。使用的关键词包括肥胖、伤口愈合、脂肪愈合、减肥手术及手术并发症。结果。大量证据表明肥胖与多种术后并发症相关。具体就伤口愈合而言，原因包括脂肪组织固有的解剖学特征、血管供血不足、细胞及成分改变、氧化应激、免疫介质变化以及营养缺乏。最近，基因阵列领域的进展使研究人员能够确定肥胖个体中一些可能导致其发病和死亡风险增加，尤其是伤口并发症风险增加的改变和缺陷。结论。虽然文献讨论了肥胖如何在多个医学方面对健康产生负面影响，但尚未有一项全面研究详细阐述肥胖相关发病机制的所有方面。对肥胖引起的生理、细胞、分子和化学变化有更深入的了解，将有助于更好地评估手术风险和结果，并制定有效的治疗方案，以改善对肥胖患者群体的护理。
