Considerations in prevention of surgical site infections following cardiac surgery: when your patient is diabetic.
The incidence of surgical site infections among patients with diabetes continues to occur at a greater rate when compared with their nondiabetic counterparts. Preexisting vascular changes, delayed wound healing, and impaired immune factors contribute. Adult patients with diabetes likely possess comorbid coronary artery disease, thus increasing the need for cardiac surgery. The resultant potential for infection can be combated with supplementary interventions above those universally taken. Modifiable risk factors of hyperglycemia and obesity are targeted preoperatively. Glycemic control, adequate tissue perfusion, and adjunct use of nasal mupirocin are addressed intraoperatively. Lastly, focus is placed on nutrition, exercise, and continued glucose control postoperatively and beyond discharge.
Streeter
Norman Blaine
NB
James A. Haley Veteran's Hospital-Cardiology, Tampa, FL 33612, USA. norman.streeter@med.va.gov
D001458:Bandages; D001786:Blood Glucose / Q000378:metabolism; D048909:Diabetes Complications / Q000097:blood / Q000451:nursing* / Q000503:physiopathology / Q000517:prevention & control*; D006331:Heart Diseases / Q000451:nursing / Q000601:surgery*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D009666:Nose / Q000382:microbiology; D009747:Nutritional Physiological Phenomena; D010353:Patient Education as Topic / Q000379:methods; D013527:Perioperative Nursing / Q000379:methods*; D011182:Postoperative Care / Q000379:methods / Q000451:nursing; D011300:Preoperative Care / Q000379:methods; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000517:prevention & control; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D013530:Surgical Wound Infection / Q000451:nursing* / Q000503:physiopathology / Q000517:prevention & control*; D014945:Wound Healing
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin