Surgical site infections following colorectal surgery in patients with diabetes: association with postoperative hyperglycemia.
BACKGROUND
Postoperative glycemic control reduces sternal infections following cardiac surgery in patients with diabetes mellitus (DM). The objective of this study was to examine the relationship between postoperative glycemic control and surgical site infections (SSI) in patients with DM undergoing colorectal resection.


CONCLUSIONS
A cohort of patients with DM who underwent colorectal resection (April 2001-May 2006) at our institution were reviewed. SSI were defined by Centers for Disease Control criteria. From a study cohort of 149 patients, 24% had poor postoperative glycemic control (defined as a mean 48-h postoperative capillary glucose (MCG) >11.0 mmol/L or 200 mg/dL), and these patients developed SSI at a significantly higher rate than those with a 48-h MCG < or =11.0 mmol/L (29.7% vs. 14.3%; odds ratio (OR) 2.5, p = 0.03). On multivariate logistic regression, 48-h MCG >11.0 mmol/L was significantly associated with SSI (OR 3.6, p = 0.02), independent of the dose and regimen of postoperative insulin administration. In conclusion, 48-h MCG >11.0 mmol/L (200 mg/dL) was independently associated with increased SSI following colorectal resection in patients with DM. Prospective studies are required to validate this relationship, address the role of preoperative glycemic control, and examine strategies to improve glycemic control following colorectal resection.
McConnell
Yarrow J
YJ
Division of General Surgery, QEII Health Sciences Centre, Dalhousie University, Victoria Building, 8th Floor, Halifax, Nova Scotia, Canada B3H 2Y9. ymcconne@dal.ca
Johnson
Paul M
PM
Porter
Geoff A
GA
D000368:Aged; D015331:Cohort Studies; D003082:Colectomy / Q000009:adverse effects*; D015179:Colorectal Neoplasms / Q000150:complications / Q000601:surgery*; D048909:Diabetes Complications / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy / Q000209:etiology*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology*
D007004:Hypoglycemic Agents; D007328:Insulin