The impact of obesity on surgical site infections in low risk procedures : a systematic review

Background: While obesity has been identified as a risk factor for post-operative surgical site infections in general, it is unclear if obesity is a risk factor for surgical site infections for low risk surgeries. Methods: A systematic review was conducted by searching PubMed, EMBASE, CINAHL and hand searching the references of included studies. Articles were included if the type of surgical procedure was low risk regardless of type of setting where the research was undertaken. All studies that used any obesity measurement were included if surgical site infections were the outcome of interest. Results: Three hundred and twenty-nine articles from three databases were identified. A full-text review of 58 articles that met inclusion criteria yielded 19 studies that were included in the analyses. Six studies had good study quality, 10 studies had fair study quality and three studies had poor study quality. Variations were noted among these studies in relation to definition of surgical site infection and cutoff levels used to define obesity. Due to heterogeneity of the definitions for surgical site infections, cutoff points for obesity and comparators, and variability of study quality, results from the studies could not answer the research question. Conclusion: The relationship between surgical site infections and obesity in the context of low risk surgeries is not yet determined. Future research should focus on patient safety reviews for low risk procedures, determine best methods to accurately measure obesity, and review obesity as a risk factor for patients undergoing low risk surgeries in all settings.Applied Science, Faculty ofNursing, School ofGraduat