• Edith Fleischmann, Andrea Kurz, Monika Niedermayr, Karl Schebesta, Oliver Kimberger, Daniel I Sessler, Barbara Kabon, and Gerhard Prager.
• Department of Anesthesia and Intensive Care, Medical University Vienna, Austria.
• Obes Surg. 2005 Jun 1; 15 (6): 813-9.

BackgroundWound infection risk is inversely related to subcutaneous tissue oxygenation, which is reduced in obese patients and may be reduced even more during laparoscopic procedures.MethodsWe evaluated subcutaneous tissue oxygenation (PsqO(2)) in 20 patients with a body mass index (BMI) > or=40 kg/m(2) (obese group) and 15 patients with BMI <30 kg/m(2) (non-obese group) undergoing laparoscopic surgery with standardized anaesthesia technique and fluid administration. Arterial oxygen tension was maintained near 150 mmHg. PsqO(2) was measured from a surrogate wound on the upper arm.ResultsA mean FIO(2) of 51% (13%) was required in obese patients to reach an arterial oxygen tension of 150 mmHg; however, a mean FIO(2) of only 40% (7%) was required to reach the same oxygen tension in non-obese patients (P=0.007). PsqO(2) was significantly less in obese patients: 41 (10) vs 57 (15) mmHg (P<0.001).ConclusionObese patients having laparoscopic surgery require a significantly greater FIO(2) to reach an arterial oxygen tension of about 150 mmHg than non-obese patients; they also have significantly lower subcutaneous oxygen tensions. Both factors probably contribute to an increased infection risk in obese patients.

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