Wound Perfusion and Oxygenation

Question 1

What factors can impact perfusion and oxygenation?

Answer 1

• Pain and stress
• Tobacco
• Obesity
• ## Hypothermia

Question 2

How does pain & stress impact perfusion and oxygenation?

Answer 2

Pain can impact oxygenation by its effect on the autonomic nervous system which can cause vasoconstriction of blood vessels, impacting the perfusion in peripheral tissues.

Anxiety and stress associated with impending pain experiences during dressing change have been linked to delayed healing.

Question 3

How does tobacco impact perfusion and oxygenation?

Answer 3

Nicotine decreases oxygen saturation in the blood and favors vasoconstriction.

This is why pre-op patients are counselled to stop smoking in advance of surgery.

Question 4

How does obesity impact oxygenation and perfusion?

Answer 4

Obese patients can experience higher cardiac and respiratory metabolic demands and comorbidities, putting them at risk for decreased oxygenation and reduced peripheral perfusion.

Obese patients are also at risk for malnutrition, which we have seen is a critical co-factor of wound healing.