Obesity and Wound Healing

Obesity is a national health concern impacting over 35% of our adult population above the age of 60.1 Obesity can be directly related to heart disease, stroke, type 2 diabetes and some cancers, but did you know that obesity also affects our ability to heal wounds?3

Several things occur as we gain weight. First, the demands on the circulatory system are stressed due to the increased amount of adipose (fat) tissue. The vascular system becomes overwhelmed and can’t supply the required oxygen and nutrients,   resulting in chronic inflammation.4  Decreased tissue oxygenation also negatively affects the ability of fibroblasts to produce collagen, a vital component for healing and wound tensile strength. 5

Secondly, the production of an important protein (adiponectin) decreases as girth increases, negatively influencing two vital components of wound healing. Adiponectin aids in stimulating angiogenesis (new blood vessel formation) as well as promoting the proliferation and migration of keratinocytes to close wounds. 5

Finally, we cannot assume that an obese person is well nourished and must have consideration for the fact that high calorie diets may be very deficient in nutrients. It is well known that an adequate supply of vitamins, minerals and protein are necessary for wound healing. 2 A proper assessment of the obese individual’s dietary requirements may reveal the need for protein supplements.

References:

  1. Adult obesity facts. CDC, 2015. http://www.cdc.gov/obesity/data/adult.html
  2. DHHS, AIM for a Healthy Weight, page 5. Available online:
    http://www.nhlbi.nih.gov/health/public/heart/obesity/aim_hwt.pdf[PDF-2.17MB]
  3. Holcomb, Valerie B & Keck, Victoria A & Barrett, J Carl & Hong, Jina & Libutti, Steven K & Nunez, Nomeli P. (n.d.). Obesity impairs wound healing in ovariectomized female mice. In vivo (Athens, Greece), 23. Retrieved from http://www.biomedsearch.com/nih/Obesity-impairs-wound-healing-in/19567384.html
  4. Obesity and Inflammation,   https://www.ncsf.org/enew/articles/articles-obesityandinflammation.aspx
  5. Pierpont YN, Phoung Dinh T, Salas R, et al. (2014). Obesity and surgical wound healing: A current review. ISRN Obesity. 2014. doi:10.1155/2014/638936.

Deep Dive

Want to learn more about this topic? In addition to the reference links above, here are some great articles and resources that you can explore.

Posted in Articles, Clinical Insights Newsletter