A bariatric patient is an individual who is severely overweight (BMI 30-39.9) or morbidly obese (BMI>40). This may lead to severely decreased mobility and the development of a variety of additional health problems.
A bariatric patient is one with a BMI over 30 and whose size and lack of mobility has effected their health.
Figure 1: Leg ulcer associated with obesityFigure 2: Dehisced abdominal wound in patient with obesity
There are a number of aspects about a bariatric patient that increase their risk for developing skin problems or chronic wounds. Poor circulation keeps damaged tissues from getting sufficient oxygen. Increased sweating and difficulty keeping themselves clean puts the patient at risk for skin maceration and breakdown. Body folds which are not cleaned multiple times a day are susceptible to intertrigo or inflammation, along with eczematous lesions and fungal growth. Bariatric patients often have limited mobility and/or problems lying prone, which can lead to the development of pressure ulcers. It is not uncommon for bariatric patients to fail to acquire the nutrients required to heal and prevent wounds.
Pressure mapping is an excellent way of assessing the risk faced by bariatric patients. Areas which are at risk for pressure ulceration can then be offloaded and monitored more closely. Beyond this, weight monitoring and regular skin assessment for areas of breakdown can help avoid or minimize wounds.
Treatments & Interventions for Bariatric Patients
To reduce the risk of pressure ulceration to the bariatric patient, the use of specialized offloading devices such as lifts, chairs, beds and commodes on a regular schedule is key. Additionally it is important to clean and dry the patients skin folds multiple times daily to reduce maceration and skin breakdown and to assess skin conditions and any emerging ulcers or wounds. It is also important to provide the bariatric patient with adequate nutrition.
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Swezey L. Top 5 ways to Prevent Skin Breakdown in Bariatric Patients. WoundSource. http://www.woundsource.com/blog/top-5-ways-prevent-skin-breakdown-bariat.... Published April 7, 2011. Accessed July 19, 2013.
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