For Obese, Body Habitus, Not BMI Impacts Op Site Infection

Thickness of subcutaneous fat, skin to lamina distance impact SSI risk post-lumbar spine fusion

WEDNESDAY, Sept. 12 (HealthDay News) -- For obese patients undergoing lumbar spine fusion surgery, the skin to lamina distance and the thickness of subcutaneous fat are significant risk factors for surgical site infection (SSI), according to a study published in the Sept. 1 issue of Spine.

In an effort to examine the role of body habitus, body mass index (BMI), diabetes, and weight distribution on developing postoperative SSI, Ankit I. Mehta, M.D., of the Duke University Medical Center in Durham, N.C., and colleagues conducted a retrospective review of 298 adult patients who underwent lumbar spine fusion surgeries between 2006 and 2008.

The researchers found that 8 percent of patients had postoperative infections, with the number of levels involved in the surgery significantly associated with infections. BMI and diabetes were not statistically significantly associated with infections. Significant risk factors for SSI included obesity (BMI of ≥30 kg/m²; P = 0.025); skin to lamina distance (P = 0.046); and thickness of the subcutaneous fat (P = 0.035).

"Our findings reveal two new risk factors for SSI after lumbar spine surgery," the authors write. "The data suggest in this particular surgical cohort that the body habitus is more significant than the BMI in the development of SSI. We encourage patients to be informed of the increased risk of infection based on the thickness of their subcutaneous fat and distance of lamina to the skin."

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