Obesity: A Risk Factor for Infection after Surgery

Obesity is a prevalent health problem all over the world. It is associated with several diseases including infections. It impairs the immune system function by plenty of mechanisms. For instance, leptin and adiponectin are cytokines produced by the adipose tissue, both participating in immunity, but their effects are impaired in obese patients. Moreover, immune cells also show defects in their functions. They produce a pro-inflammatory state and contribute to obesity-related diseases. Innate immune system and adaptive immunity are both impaired in obese patients which causes a poor response to infections. In addition, in surgical site infections (SSI), there are local factors that must be considered. The large adipose panicle and visceral adipose tissue increase the surgical technique difficulty and extend the operative time. Besides, the adipose tissue has poor oxygenation and reduces operative field. It has been proven that obesity is associated to surgical site infection irrespective of type of surgery. However, minimal invasive surgery has demonstrated that reducing surgical trauma can diminish the risk for surgical site infection.