The Impact of Glycosylated Hemoglobin and Diabetes Mellitus on Wound-Healing Complications and Infection After Foot and Ankle Surgery

Humphers, Jon M.; Shibuya, Naohiro; Fluhman, Benjamin L.; Jupiter, Daniel C.

doi:10.7547/0003-0538-104.4.320

Cited by 43 publications

(28 citation statements)

References 44 publications

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“…studied 10,532 patients with uncontrolled DM undergoing cervical spine surgery and found that uncontrolled DM was associated with a significant increase in the prevalence of postoperative cardiac, respiratory, and genitourinary complications, pulmonary embolism, and postoperative infection. Furthermore, Humphers et al . and Han and Kang reported in retrospective studies that elevated HbA1c level was an independent risk factor for postoperative complications in patients with DM undergoing orthopedic surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The theoretical risk of poor surgical outcomes incurred by patients with comorbid DM is quite accepted given the known negative impact of DM on wound healing established by numerous experimental and clinical studies . The effect of preoperative glycemic control on postoperative complications has also been well studied in many fields such as thoracic and cardiovascular surgery, neurosurgery, and orthopedic surgery …”

Section: Discussionmentioning

confidence: 99%

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The impact of diabetes mellitus on outcomes of endoscopic sinus surgery: a nested case‐control study

Hajjij

Mace

Soler

et al. 2015

Int Forum Allergy Rhinol

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Background Given the immune impairment associated with diabetes mellitus (DM), its impact on chronic rhinosinusitis (CRS) is a potentially relevant concern, yet it has not been well-studied. A single retrospective study reported worse post-operative quality of life outcomes in diabetic CRS patients. Our study evaluated the effect of comorbid DM on outcomes of endoscopic sinus surgery (ESS) using a prospective study design. Methods Using a multi-centered, prospective cohort of patients (n=437) undergoing ESS for recalcitrant CRS, a nested case-control comparison was performed between 20 DM adult patients (cases) and 20 non-diabetic patients (controls), matched 1:1 for age and Lund-Mackay CT scores. Outcome measures included 22-item Sinonasal Outcome Test (SNOT-22), Rhinosinusitis Disability Index (RSDI), Patient Health Questionnaire (PHQ-2), and Brief Smell Identification Test (BSIT). Results Mean follow-up was similar between cases (12.6[6.0] months) and controls (12.9[5.9] months; p=0.862). All preoperative scores were statistically equivalent between DM and non-DM cohorts. Both cohorts showed significant post-ESS improvement in SNOT-22 (p=0.001) and RSDI scores (p<0.001), and no significant change in PHQ-2 or BSIT scores. The magnitude of score changes was statistically equivalent between the two cohorts for all outcome measures with no differences in postoperative score changes between insulin-dependent diabetics and those managed by oral hypoglycemics or dietary restriction (p≥0.444). Conclusions Diabetic CRS patients experience similar degrees of symptomatic benefit from ESS compared to controls. Insulin dependence does not appear to adversely affect surgical outcome but a larger cohort would better assess the effect of diabetes type and control on surgical outcomes in CRS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The impact of diabetes mellitus on outcomes of endoscopic sinus surgery: a nested case‐control study

Hajjij

Mace

Soler

et al. 2015

Int Forum Allergy Rhinol

View full text Add to dashboard Cite

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“…Three studies were excluded due to overlapping results [22,24,25]. Since June 2011 the unit of measurement of HbA1c has changed from % to mmol/mol.…”

Section: Data Extractionmentioning

confidence: 99%

Systematic review of the impact of HbA1c on outcomes following surgery in patients with diabetes mellitus

et al. 2016

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“…25 The rate of SSI in our control group is lower than that recently reported in a cohort of diabetic patients. 15,16 This retrospective study identified 322 diabetic patients from a series of 3795 patients who underwent ankle and/or foot surgery. The overall rate of postoperative infection was 28.9% in patients with DM, and the average surgical time was 75 minutes.…”

Section: Discussionmentioning

confidence: 99%

Topically Applied Vancomycin Powder Reduces the Rate of Surgical Site Infection in Diabetic Patients Undergoing Foot and Ankle Surgery

2016

Fuß & Sprunggelenk

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The Impact of Glycosylated Hemoglobin and Diabetes Mellitus on Wound-Healing Complications and Infection After Foot and Ankle Surgery

Abstract: In this retrospective study, HbA1c level had the strongest association with postoperative foot and ankle surgery complications in patients with diabetes.

Cited by 43 publications

References 44 publications

The impact of diabetes mellitus on outcomes of endoscopic sinus surgery: a nested case‐control study

The impact of diabetes mellitus on outcomes of endoscopic sinus surgery: a nested case‐control study

Systematic review of the impact of HbA1c on outcomes following surgery in patients with diabetes mellitus

Topically Applied Vancomycin Powder Reduces the Rate of Surgical Site Infection in Diabetic Patients Undergoing Foot and Ankle Surgery

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