Journal of the American College of Surgeons
Volume 210, Issue 4 , Pages 381-389 , April 2010

Percent Body Fat and Prediction of Surgical Site Infection

Presented at the American College of Surgeons 95th Annual Clinical Congress, Chicago, IL, October 2009.

  • Emily Waisbren, BS

      Affiliations

    • Plastic Surgery Division, Brigham and Women's Hospital, Boston, MA
  • ,
  • Heather Rosen, MD, MPH

      Affiliations

    • Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA
    • Department of Plastic Surgery, Children's Hospital Boston, Boston, MA
  • ,
  • Angela M. Bader, MD, MPH

      Affiliations

    • Anesthesia and Center for Preoperative Evaluation, Brigham and Women's Hospital, Boston, MA
  • ,
  • Stuart R. Lipsitz, ScD

      Affiliations

    • Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA
  • ,
  • Selwyn O. Rogers Jr, MD, MPH, FACS

      Affiliations

    • Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA
    • Division of Trauma, Burn, and Surgical Critical Care, Brigham and Women's Hospital, Boston, MA
  • ,
  • Elof Eriksson, MD, PhD, FACS

      Affiliations

    • Plastic Surgery Division, Brigham and Women's Hospital, Boston, MA
    • Corresponding Author InformationCorrespondence address: Elof Eriksson, MD, PhD, Plastic Surgery Division, Brigham and Women's Hospital, 45 Francis St, Boston, MA 02115

Received 6 November 2009 ,Revised 21 December 2009 ,Accepted 5 January 2010.

References 

  1. Mangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection, 1999 (Hospital Infection Control Practices Advisory Committee). Infect Control Hosp Epidemiol. 1999;20:250–278quiz 79−80
  2. Haley RW, Culver DH, White JW, et al. The nationwide nosocomial infection rate (A new need for vital statistics). Am J Epidemiol. 1985;121:159–167
  3. Stone PW, Larson E, Kawar LN. A systematic audit of economic evidence linking nosocomial infections and infection control interventions: 1990−2000. Am J Infect Control. 2002;30:145–152
  4. Anaya DA, Dellinger EP. The obese surgical patient: a susceptible host for infection. Surg Inf. 2006;7:473–480
  5. Choban PS, Flancbaum L. The impact of obesity on surgical outcomes: a review. J Am Coll Surg. 1997;185:593–603
  6. Flancbaum L, Choban PS. Surgical implications of obesity. Ann Rev Med. 1998;49:215–234
  7. Choban PS, Heckler R, Burge JC, Flancbaum L. Increased incidence of nosocomial infections in obese surgical patients. Am Surg. 1995;61:1001–1005
  8. World Health Organization. Obesity: Preventing and Managing the Global Epidemic (Report on a WHO Consultation on Obesity). Geneva: World Health Organization, 305 June; 1997;WHO/NUT/NCD/98.1; 1998
  9. Willett WC, Dietz WH, Colditz GA. Guidelines for healthy weight. N Engl J Med. 1999;341:427–434
  10. Frankenfield DC, Rowe WA, Cooney RN, et al. Limits of body mass index to detect obesity and predict body composition. Nutrition. 2001;17:26–30
  11. Gallagher D, Heymsfield SB, Heo M, et al. Healthy percentage body fat ranges: an approach for developing guidelines based on body mass index. Am J Clin Nutr. 2000;72:694–701
  12. Micozzi MS, Albanes D, Jones DY, Chumlea WC. Correlations of body mass indices with weight, stature, and body composition in men and women in NHANES I and II. Am J Clin Nutr. 1986;44:725–731
  13. Ravussin E, Swinburn BA. Pathophysiology of obesity. Lancet. 1992;340:404–408
  14. Smalley KJ, Knerr AN, Kendrick ZV, et al. Reassessment of body mass indices. Am J Clin Nutr. 1990;52:405–408
  15. Kyle UG, Bosaeus I, De Lorenzo AD, et al. Bioelectrical impedance analysis—part I: review of principles and methods. Clin Nutr. 2004;23:1226–1243
  16. Kyle UG, Bosaeus I, De Lorenzo AD, et al. Bioelectrical impedance analysis-part II: utilization in clinical practice. Clin Nutr. 2004;23:1430–1453
  17. Bray GA. Health hazards of obesity. Endocrinol Metab Clin North Am. 1996;25:907–919
  18. Roubenoff R, Dallal GE, Wilson PW. Predicting body fatness: the body mass index vs estimation by bioelectrical impedance. Am J Public Health. 1995;85:726–768
  19. Lukaski HC, Bolonchuk WW, Hall CB, Siders WA. Validation of tetrapolar bioelectrical impedance method to assess human body composition. J Appl Physiol. 1986;60:1327–1332
  20. Hsieh FY, Bloch DA, Larsen MD. A simple method of sample size calculation for linear and logistic regression. Stat Med. 1998;17:1623–1634
  21. Canturk Z, Canturk NZ, Cetinarslan B, et al. Nosocomial infections and obesity in surgical patients. Obes Res. 2003;11:769–775
  22. Dindo D, Muller MK, Weber M, Clavien PA. Obesity in general elective surgery. Lancet. 2003;361:2032–2035
  23. Merkow RP, Bilimoria KY, McCarter MD, Bentrem DJ. Effect of body mass index on short-term outcomes after colectomy for cancer. J Am Coll Surg. 2009;208:53–61
  24. Mullen JT, Davenport DL, Hutter MM, et al. Impact of body mass index on perioperative outcomes in patients undergoing major intra-abdominal cancer surgery. Ann Surg Oncol. 2008;15:2164–2172
  25. Tuech JJ, Regenet N, Hennekinne S, et al. Laparoscopic colectomy for sigmoid diverticulitis in obese and nonobese patients: a prospective comparative study. Surg Endosc. 2001;15:1427–1430
  26. Hopf HW, Hunt TK, West JM, et al. Wound tissue oxygen tension predicts the risk of wound infection in surgical patients. Arch Surg. 1997;132:997–1004discussion 1005
  27. Fantuzzi G. Adipose tissue, adipokines, and inflammation. J Allergy Clin Immunol. 2005;115:911–919quiz 20
  28. Hartmann M, Jonsson K, Zederfeldt B. Effect of tissue perfusion and oxygenation on accumulation of collagen in healing wounds (Randomized study in patients after major abdominal operations). Eur J Clin Nutr Acta Chir. 1992;158:521–526
  29. Lamas O, Marti A, Martinez JA. Obesity and immunocompetence. Eur J Clin Nutr. 2002;56(Suppl 3):S42–S45
  30. Nieman DC, Henson DA, Nehlsen-Cannarella SL, et al. Influence of obesity on immune function. J Am Diet Assoc. 1999;99:294–299
  31. Pond CM. Adipose tissue and the immune system. Prostaglandins Leukot Essent Fatty Acids. 2005;73:17–30
  32. Stallone DD. The influence of obesity and its treatment on the immune system. Nutr Rev. 1994;52:37–50
  33. Elmadfa I, Meyer AL. Body composition, changing physiological functions and nutrient requirements of the elderly. Ann Nutr Metab. 2008;52:2–5

 Disclosure Information: Nothing to disclose.

PII: S1072-7515(10)00007-4

doi: 10.1016/j.jamcollsurg.2010.01.004

Journal of the American College of Surgeons
Volume 210, Issue 4 , Pages 381-389 , April 2010