New protocol for surgical patients in Wales

There's an abundance of evidence supporting the negative effects that smoking and obesity can have on surgical and wound recovery times. As a result, health care professionals in Cardiff and the Vale of Glamorgan are beginning to take steps toward educating those who are scheduled to undergo non-emergency surgical procedures.

In the news
According to BBC News, patients who smoke or are considered obese will have to undergo "lifestyle" courses before having planned surgeries starting December 1.1 This is in an effort to help the individuals make healthier life decisions moving forward, by providing support and advice in adapting their habits.

"Nobody has to quit or lose weight but there is clear evidence showing that any changes can reduce the risk of complications in surgery, reduce recovery time and improve your chances of a successful surgery," Dr. Sharon Hopkins explained to the source. "But some people do manage to quit or lose weight, which is absolutely great for them, their health and their surgical results."

It is believed that nearly 2 percent of the adult population in Cardiff and Vale has a body mass index of more than 40 and 21 percent of these individuals smoke, which is what has led to this new policy. In the last several months, there has been a great deal of disagreement over whether or not it should be put into place. Of course, the requirements are not relevant for someone who is in need of emergency surgery, but it is unclear how successful the courses will be.2

Effects of obesity
According to Science Daily, professionals from Laval University evaluated the risk of obesity on patients in 2009. The research included anyone with a BMI of 40 or greater, which made up 3 percent to 4 percent of the population at that time. Specifically, those who suffered from both obesity and issues such as past instances of heart failure, current levels of high blood pressure or a history of blood clots had increased risks for experiencing other health issues during surgery.3

"Since recovery can be a problem for these patients, we recommend that they take steps to be as healthy as possible before going into surgery," Dr. Paul Poirier, lead author on the study, told the source. "For example, the person with diabetes should get his or her blood sugar under control."

This is where programs such as those soon to take place in Wales come into play. Educating patients on the problems associated with their current weight and undergoing surgery is a great start, but many need further guidance.

Smoking and wound healing
However, obesity is not the only health issue to be seen to have negative effects on postoperative patients. Someone who decides to smoke while their wound from a major surgery is trying to heal will experience issues. According to the University of Wisconsin, the blood vessels become smaller when an individual smokes. As a result, these vessels have a difficult time transporting oxygen, nutrients and other healing contributors to a wound site.4 Therefore, most will experienced prolonged healing times if they opt to smoke, even occasionally, following surgery. The source also cites a number of issues that may arise when one chooses to smoke during recovery:

  • blood clots
  • infections
  • prolonged hospital stays
  • illnesses ranging from a cold to pneumonia
  • unnecessary scarring
  • unsuccessful skin grafts

Health care professionals interested in purchasing surgical equipment can visit Medex Supply online. Individuals will also find a number of wound care supplies readily available from the company.

1 BBC News, "Pre-surgery weight and smoking courses rolled out in Cardiff and Vale" November 25, 2013
2 Walesonline, "Smokers and obese face pre-surgery courses from December 1" November 25, 2013
3 Science Daily, "Severe obesity increases risk of health problems during surgery" June 22, 2009
4 UW Health, "Smoking and wound healing: a guide for surgical and burn patients" May 14, 2013

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