# Question - Infection - surgery



## jbason (Mar 30, 2007)

first post, 
finally jumping in. 

In so many place I keeping hearing about one of the risk of weight being infection. 

I have someone dear to me who's going in for a neccessary non weight related surgery. but is being told over and over that because of her size she at great risk for infections that she is getting quite scared about the whole procedure. Is there a direct link? does anyone know or understand or have a guess at how weight makes a bigger risk of infection. Do us big people get more infections in surgical situations? Or is it because the medical 'business' is less equipped /prepared/ willing to make sure that we get reasonable quality care? 


Inquiring minds want to know


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## AnnMarie (Mar 30, 2007)

To put it simply.... yes. Fat is more susceptible to infection. 

From what I've been told (doctors and my mother, a nurse, and patients I know who've had hard times healing) is that fat cells, adipose tissue, is more likely to hold on to any bacteria when there is a surgery and provides an ideal breeding ground for it when the incision is closed up. 

I know two people who've actually been "left open" for their wound to heal after having a problem with infections. The wound is packed and cleaned, but not stitched, it slowly heals as you add less packing, etc. Gross, yeah... but hey... better than dying of an infection!

So, yeah... from what I understand she's being told the right thing, and you have to just be very diligent after surgery and heed any warnings of infection (tenderness, redness, etc).


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## chunkeymonkey (Mar 30, 2007)

Yes I had surgery and my incision was infected. I had a c-section and it was infected they sent me home with antibiotics and a nurse until I healed. The next day the nurse checked my incision and said go to the ER. When I was there they opened back up the incision and cleaned it out to get rid of the infection. Once an incision is re opened it can not be sewn back it has to be packed with gauze and saline until it heals on its own.....resulting in a bigger scar. One way to look at your risk of infection is to look at how you heal in the past to minor cuts or major to your legs. People who are more likely to have infections have a longer time healing to minor cuts on their legs.Not that it is the same for everyone. Any surgery is risky for Fat people not just because of infection but for anesthesia issues. Once you are put under its much harder for an anesthesalogist to control your heart and breathing and you have an increased risk of complications of waking from anesthesia. If you have a great dr. they will go through the risks in detail and make you feel more comfortable with the issue. 
Hope this helps a little.


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## Tina (Mar 31, 2007)

I had surgery in January on some large stomach hernias. I have about a 6" incision. Kept it fastidiously clean, and not only did I not get an infection, it healed quickly. So, I'd say that it depends upon where it is, and how clean it is kept, amongst some other factors, I'm sure.


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## jbason (Mar 31, 2007)

It does help. I'm worried for her, I also what to put her at ease, 
I've already put my foot in my mouth. 
her surgery was originally on a Wednesday- I told her that that was great 
because it seems as if statistical mid week procedures on average go much better, compared to weekend /friday ones. which was fine. 

then today she called me to tell me they moved her date - of course to a friday so she's even more nervous. :doh: 
got to watch what i say. I'm just trying to be supportive as I can. The sad thing is that shes gotten so sick mostly because her GP didn't take her complaints seriously and just wrote them off as just a side effect of being fat. She rightly distrust the medical profession. It's good thing that the ones she's been dealing with lately have been good and proffesional or she would have long given up hope of getting proper help. But she's had a struggle each time she's visited the hospital where the surgery will take place getting a wheelchair that was big enough, and the hospital does not have blood pressure cuffs suitable for supersized patients  .


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## Tracyarts (Mar 31, 2007)

It is an unavoidable risk, but there are things that can be done to manage and minimize the risk.

If a patient (of any size) has diabetes or any other metabolic condition that can make them susceptible to infection or which makes them a slow healer, they should do whatever they can to gt that condition under control as tightly as possible before the surgery. 

And follow the doctor's orders to the letter when it comes to postsurgical incision care. And care in general to make sure you do not strain or otherwise hurt the incision as it heals. 

I had abdominal surgery going on two years ago, and have about a ten inch incision that starts above my belly button, curves around it, and ends several inches below it. I was told from the start by both surgeons I consulted with that I was at *extreme* high risk of infection and the incision turning into a wound.

My surgeon said that aside from getting and maintaining tight control over my blood glucose level and being careful to follow his instructions after being discharged from the hospital, there was not much more I could to except wait and see what happens and whatever happened, we would deal with it as it came. 

I was lucky and I healed very well and very quickly. Now, when they went to remove my staples, I was not quite ready and the very top of the incision separated a little when he removed the first three staples. The surgeon closed it with butterfly bandages and we kept them on it and waited another week or so to remove the rest of the staples. I have a bit of a wider scar where the incision was not quite ready, but it healed just fine. 

Something I did which is a bit unorthodox but I think really helped, was to purchase a guided visual imagery and healing affirmation CD for successful surgery before I had surgery. I listened to it in the couple of weeks leading up to my surgery, while I was in the hospital, and after I was discharged. Part of the imagery was to visualize your body healing, the tissues reconnecting and growing together, etc... I am not sure what, if any, listening to the CD helped. But, my doctor was very surprised at how fast and well and easily I healed. 

I don't know where the CD is now, but the woman who narrated the visualizations is Belleruth Naparstek. You can probably look up by her name. I want to say the CD title was "successful surgery". If nothing else, it was soothing and comforting to listen to. I highly reccomend it.

Tracy


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## Tina (Mar 31, 2007)

There is absolutely no excuse for them not to accomodate fat people there. What about hospital gowns; do you know if they have gowns that will accomodate her.


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## wrench13 (Mar 31, 2007)

I was in major motorcycle crash 6 yrs ago, snapped my lower left leg in half, bones stickin' thru my pants and riding boots, bones scrapin' on the road. 

Know what got it infected? A staff infection, at one of the most prestigious NYC hospitals for special surgery. 

I would check out the stats for the hospital she's gonna use and see what the incidence of that type of infection is. Staff infections are no fun, 2 weeks in the hospital, being opened up every other day to have them clean the wound and re-pack it with anti-biotic beads. 

I wish her all the luck in the world.


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## BubbleButtBabe (Mar 31, 2007)

Wrench13 is right..Being fat is not the only reason for infections..Staph is nasty stuff and I have a couple of friends that have had it..Took almost a month of hospital care for one to get rid of it..

She may get an infection if she is allergic to the internal stitches they use along with the staples or the catgut..My son and I are both allergic to stitches that use teflon in them..He had such an infection on his knee after his surgery it took 2 months of packing the gauze 3 times a day to clear it up..I wont describe what it looked like but it was nasty..Sad part is he kept telling the Dr. it wasn't healing right and noone would listen to him..It took him showing the therapist how nasty it looked for them to get concerned..

I had a bone spur taken off my ankle and it wasn't healing right..It was the stitches they used..Same as what they used on my son..BTW taking antibiotics wont help..The stitches have to be taken out for the infection to stop..


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## Sweet Tooth (Mar 31, 2007)

What about the use of prophylactic antibiotics? Has that helped anyone?

I haven't had surgery in almost 30 years [I was fat, but a kid], so I couldn't tell you about healing from surgery. I know that other wounds heal just fine on me so long as I don't use any sort of ointment with aloe because that's something I'm allergic to.


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## prettyssbbw (Apr 1, 2007)

I had surgery last year and they gave me the bikini cut. Which is under my very large tummy. It was a 9 inch wide cut. They gave me staples and stitches. And they had me taking prophylactic antibiotics. I had to stay in the hospital for 6 days and then have a nurse coming to visit me for about a month after.My incision never did get infected. For the first 3 weeks they were cleaning it once a day with saline and putting those bandages on.A couple of days after i got home (it was summertime) i had my windows open and didn't know a screen had come off so a bat got in my house and i sprang up off the couch and ran thus opening about 2 inches of my incision but with some extra special care it healed nicely.Tell your friend not to worry too much.She will be ok. My doc was so sure i was going to get an infection that she made me wear one of those wound vac machines that was supposed to suck the infection out.But it was not infected so after 2 days of wearing that horrid thing i made them remove it.And i am glad that i did! Because now my scar is barely noticeable.I am sorry if i am all over the place here but it is 1am here and i'm sleepy LOL. Good luck to your friend.If you have any more questions feel free to pm me! HUGS,natasha


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## Miss Vickie (Apr 1, 2007)

Sweet Tooth said:


> What about the use of prophylactic antibiotics? Has that helped anyone?



Folks usually get a dose in the OR, right after closing. The problem with prophylactic antibiotics is that a) antibiotics kill not just the bad bacteria but the good stuff as well, stuff that helps protect the body and help you heal, and b) if you're on antibiotics already, that makes cultures, particularly blood cultures, not be diagnostically significant. The best way to find the best antibiotic to work on an infection is what's called a culture and sensitivity, which you can't do when someone is on antibiotics because it skews the results.

Bjason, tell your friend that more significant than her weight is her hospital's rate of wound infections. That'll give her a good picture of what to expect. Yes, adipose tissue (aka fat) does have more of a likelihood of infection, because it's not as vascular as other tissue and so it gets infected easier, and stays infected longer. But not every fat person gets a wound infection. I've had three surgeries as a fat woman and none of them got infected, or dehisced (came apart) which was my WORST fear. 

Oh, and hand washing never hurts. Before anyone touches your friend, she should make sure they've washed their hands and ASK THEM if they've washed their hands. (I'm a nurse and I'm not offended at all when I'm asked this). She should also be fastidious while in the hospital -- clean hands, clean gown, clean bedding. And once she gets home, same thing -- clean clothes, clean hands, clean bedding.

I wish for her an uneventful and successful surgery and a quick and easy, uncomplicated recovery.


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