Background: Obesity, characterized by excess fat accumulation, is associated with heightened inflammation and infection risk. However, the relationship between body mass index (BMI) and wound healing remains unclear. Objective: The study aimed to explore the relationship between BMI and wound infection incidence, pathogenic bacterial strains in wounds, and wound healing promotion using different BMI values in conventional medical dressings. Methods: The study included 120 patients with traumatic and orthopedic wound infections and 40 patients with vertebral fractures to assess dressing efficacy and the influence of BMI index on healing outcomes. Wound infection incidence rates, pathogenic bacteria distribution within groups, and antibiotic resistance were identified, and their association with BMI was evaluated. Factors contributing to wound infection were analyzed. Results: The wound infection incidence rate was 30.36% without statistically significant correlation with BMI ([Formula: see text]). A weak correlation ([Formula: see text]) was established between the distribution of pathogenic bacterial strains with cause of trauma and BMI ([Formula: see text]). Wound exposure time ([Formula: see text]), wound depth ([Formula: see text]), and hospital stay ([Formula: see text]) were identified as independent wound infection risk factors. Conclusions: BMI exhibited a weak correlation with pathogenic bacteria distribution and negatively correlated with the degree of wound healing.