Association Between Obesity and Wound Infection Following Colorectal Surgery: Systematic Review and Meta-Analysis

Background: The aim of this meta-analysis is to comprehensively review and quantify the excess risk of surgical site infections (SSI) in obese patients following colorectal surgery. Methods: A systematic electronic search of the MEDLINE and EMBASE databases identified studies that investigated the association of obesity, defined by body mass index (BMI) with SSI among colorectal surgery patients. Results: Twelve studies were included in the final analysis. Patients with BMI ≥30 kg/m² were at 1.5 times (pooled OR 1.51, 95% CI: 1.39, 1.63, p < 0.001) higher odds of developing SSI after colorectal surgery when compared to BMI <30 kg/m². Subgroup analysis of the eight studies that investigated only elective procedures showed that the odds of developing SSI when BMI ≥30 kg/m² is 1.6 times that of those with BMI <30 kg/m² (pooled OR 1.60; 95% CI 1.34, 1.86; p < 0.001). The odds of having SSI when BMI is 25–29.9 kg/m² are 1.2 times than those with BMI <25 kg/m² (pooled OR 1.17; 95% CI 1.07, 1.28; p < 0.001). Conclusion: Overweight and obese patients carry at least 20% and 50% higher odds of developing SSI after colorectal surgery compared to normal weight patients, respectively.