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Examining Scars to Pinpoint Healing Problems in Obese Patients after Surgery

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Examining Scars to Pinpoint Healing Problems in Obese Patients after Surgery

March 18, 2010

While obesity is known to cause significant health risks, researchers wanted to understand why many surgical procedures resulted in complications among obese population. After abdominal surgery, many obese patients experience incisional hernias. The link between healing and obesity has not been clarified completely, though scientists were fairly certain it involved a problem with internal scarring causing abdominal pressure on patients. In the past, healing problems have been closely linked to infection, malnutrition, technical failure, blood loss, and more factors. But researchers wanted to see if obesity had an influence upon healing. A new study aimed to see if problems with scarring led to these complications in obese people.

The study focused on lab rats and how abdominal wounds heal for obese rats days after a laparotomy. A laparotomy is a surgical procedure that creates an incision that goes through the abdominal wall to access the abdominal cavity to allow access to main organs like the lower digestive tract, liver, pancreas, spleen, bladder, uterus or ovaries, kidneys, or appendix.

Thirty-six rats were divided into two groups. One group acted as the “control” and the other acted as the “experiment group.” The control group of rats was given a standard diet while the experiment group was given a high-calorie diet. This caused the experiment group to weigh more, on average, than the control group. 166 days after these diets began; both groups were given laparotomies and subsequently given laparorrhaphies, which closes abdominal incisions with sutures. After seven days some rats were euthanized. Then fragments were taken from surface skin scars that had formed. Researchers also took fragments from internal tendon scars. The remaining rats were examined in this way  after fourteen days. Scientists did this to examine more advanced scar-healing as well.

After careful analysis, researchers found no significant different in cutaneous scars, or scars that form on the skin. However, in the control group, researchers found that the aponeurotic scars, or scars that form on internal tendons, were in fact more resistant after both seven and fourteen days. In the past, some researchers hypothesized that obese patients have problems with abdominal healing (hernias, etc) because of collagen density or inflammatory skin problems. However, in this new study, researchers found that these factors were the same in both the control and the experiment group. This negated any theories that healing on the skin was the cause of complications.

Now that there is proof of internal scarring problems, doctors and patients may have to counsel more seriously about weight-loss before abdominal surgery. Doctors may need to develop a way to ensure that patients heal properly internally, where incisions were made to tendons. This could prevent the influx of hernias and complications among obese patients. Studies like this continue to prove that the growing obesity epidemic is both detrimental to the health of patients but also to the advances of modern medicine. Surgical procedures that would not otherwise result in complications, are becoming more dangerous due to the unhealthy nature of patients.

Source: Scielo Brazil and Abstract on PubMed


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