Decubitus Ulcer Management: Post-flap Complications Increased in the Obese

Dr. Greg Vigna

Study shows that BMI may be linked to wound complications after surgery, with obese patients experiencing higher rates of dehiscence

This study confirms that flaps in obese individuals have increased wound dehiscence, which is likely related to the relative avascularity of fatty tissue and a tendency for this tissue to dry out.”

— Greg Vigna, MD

SANTA BARBARA, CA, UNITED STATES, March 3, 2025 /EINPresswire.com/ -- "Conclusions: Our findings suggest that BMI's may be correlated with early wound status and the incidence of postoperative complications, while it may not be correlated with osteomyelitis status,” states Dr. Stuti Garg, Plastic Surgeon, Northwestern University Feinberg School of Medicine.

Greg Vigna, MD, JD, national decubitus

ulcer attorney, former long-term acute care hospital physician, states, “This study confirms that flaps in obese individuals have increased wound dehiscence, which is likely related to the relative avascularity of fatty tissue and a tendency for this tissue to dry out. It is good to see high powered plastic surgery programs publishing articles on reconstructive surgery as early flap surgery is appropriate, and for osteomyelitis flaps, surgery is curative.”

What did Dr. Garg report in the article “Evaluating the Effect of BMIs on Wound Complications After the Surgical Closure of Pressure Injuries” published Surgeries 2025, 6, 5?:

"Results: In total, 68 patients were included. Out of these, 13% of patients were underweight, 29% were normal-weight, 35% were overweight, and 22% were obese. Post-op day 14 complications occurred in 22% of underweight patients, 15% of normal-weight patients, 38% of overweight patients, and 40% of obese patients.

Of all recorded complications, 75% of patients were overweight or obese. Complication rates were not significantly different based on osteomyelitis status.

There were no significant differences in wound status outcomes between the Fluid Immersion Simulation System (Dolphin) and the air-fluidized therapy (Clinitron.)”

Read Dr. Garg’s article: https://www.mdpi.com/2673-4095/6/1/5

What does the Wound Healing Society Guidelines 2023 update say about flaps for cure?

“Preamble: Surgical treatment of pressure injury/ulcers is often considered to be a final invasive choice for wounds refractory to less aggressive care or for use when rapid closure is indicated, however, recent literature suggests that surgery can and should be performed safely in properly selected patients.”

Read the WHS guidelines: https://onlinelibrary.wiley.com/doi/full/10.1111/wrr.13130

Greg Vigna, MD, JD, is a national malpractice attorney who has managed hundreds of patients with serious bedsores pre-flap and post-flap. He is available for legal consultation for families and patients who have suffered decubitus ulcers due to poor nursing care at hospitals, nursing homes, or assisted living facilities. The Vigna Law Group, along with Ben C. Martin, Esq., of the Ben Martin Law Group, a Dallas, Texas national pharmaceutical injury law firm, jointly prosecute hospital and nursing home neglect cases that result in bedsores nationwide on a non-exclusive basis.