A Study of the Effect of Obesity on Abdominal Surgical Wound Healing Process in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State.

Oroleye, Aderonke Folasade (2015-05-14)

Thesis

This study examined the major factors that contributed to surgical wound healing in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife. It determined the differences between sex, age and obesity on surgical wound healing process with a view to providing information on specific methods and clinical approaches that could be adapted to facilitate clinical efficiency and prevent prolonged hospitalization. A structured interview guide with observational check-list was constructed and used pre and post-operatively on the patients for the study. It was tested for validity and reliability (correlation coefficient value of 0.76) before it was used to elicit responses from 53 obese and 30 non-obese participants that had abdominal surgery. All the participants had their packed cell volume (PCV) checked pre-operatively. The patients' case files and laboratory results were reviewed to complete the bio-data information in the interview guide and observational check-list. Patients' wounds were assessed using a 3-levels dimensional scale (satisfactory, fairly satisfactory and unsatisfactory) with scored parameters check-list by noting the skin sensation, temperature, colour, discharge and apposition of the edges of the incision. Data collected were analysed using both descriptive and inferential statistical methods. The result showed that consumption of mainly energy-giving food items (85%), lack of any form of exercise (90%) and genetic influence (78%) were factors which contributed to obesity in the environment. It also found that 70% non-obese (BMI<30) respondents had satisfactory wound healing with healing score index category 13-17 while 33.9% obese respondents had satisfactory wound healing with the same healing score index category. Majority of the obese (66.1%) presented with wound break down and prolonged wound healing processes. The study further showed that a significant difference existed between obese and non-obese surgical patients' wound healing processes (Mean square between groups was 10.4 versus mean square within groups of 3.8, F-ratio = 2.714, P < 0.05). Finally, sex and age had no significant difference on surgical wound healing processes in the obese (M:F mean score was 14.4 versus 13.5, (t=1 .194, P>0.05). In conclusion, the study showed that obese patients were more prone to wound break down and prolong wound healing processes.

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