Case Study• 47 year old female• Weight = 505 lbs• Height = 5’6”• BMI = 81.5• Medical History: Asthma, sleep apnea,

pulmonary hypertension, arterial hypertension, diabetes, DVT, osteoarthritis, non union of tib-fib fracture, bedrest for 1 year. Mother reports that she had a “draining sore spot” on her coccyx before admission

Surgery & Initial Postop Course

• Roux en Y gastric bypass on August 2, 2002• Initial Postoperative Course

Ventilator dependencyTracheostomyAtrial fibrillationStrokeFluid and electrolyte imbalancesDiarrhea from tube feedingSepsis from TPNAcute renal failureRashes from plastic allergy and Candida

One Month Postoperatively• Height = 5’6”

• Weight = 395 lbs

• BMI = 63.7

• Albumin = 2.7

• Still on ventilator in AICU

• Renal failure recovering– off SLED

• Multiple skin and wound problem

Bariatric S1 Overview

Bariatric S1 Ulcer 1eSeptember 5, 2002

Bariatric S1 Ulcer 1fSeptember 5, 2002

Bariatric S1 Ulcer 1gSeptember 5, 2002

Bariatric S1 Ulcer 1hSeptember 5, 2002

Bariatric S1 ThighSeptember 10, 2002

Bariatric S1 Finger DepthSeptember 10, 2002

Bariatric S1 PackingSeptember 10, 2002

Bariatric S1 Packing 2September 10, 2002

Bariatric S1 PackedSeptember 10, 2002

Bariatric S1 Ulcer 1aSeptember 12, 2002

Bariatric S1 Ulcer 1bSeptember 12, 2002

Bariatric S1 Ulcer 1cSeptember 12, 2002

Bariatric S1 Ulcer 1dSeptember 12, 2002

Bariatric S1 CloseSeptember 18, 2002

Bariatric PU1September 18, 2002

Bariatric S1PU3September 18, 2002

Bariatric DressingSeptember 18, 2002

Bariatric S1 OR69-19-02

Bariatric S1 OR59-19-02

Bariatric S1 OR49-19-02

Bariatric S1 OR39-19-02

Bariatric S1 OR29-19-02

Bariatric S1 OR19-19-02

Bariatric S1 postop vacSeptember 26, 2002

Bariatric S1 postop vac2September 26, 2002

Bariatric S1 PU410-9-02

Bariatric S1 PU310-9-02

Bariatric S1 PU210-9-02

Bariatric S1 PU110/9/02

Bariatric S1 Breast Fold 1around 9-5-02

Bariatric S1 Breast Fold 2around 9-19-02

Bariatric S1 healing breast fold10-9-02