These results suggest that PDE 5 inhibitors may play a more important role in early postoperative skin flap viability rather than at later time points and may be beneficial for skin flap viability as shown in the rat model. PDE 5 inhibitors may reduce the extent of necrosis after reconstructive surgeries.

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Blood glucose monitoring may be a crucial, additional role for the circulating nurse. Blood glucose levels can be determined quickly and easily by using a puncture device and reagent pads. Blood glucose meters vary from $130 to $480 and have been reported to be reliable. These monitors decrease the need for additional people in the operative environment to take specimens, thus decreasing the microorganisms in the room from additional personnel and movement. The blood glucose value may determine when additional insulin is needed, thus enhancing the diabetic physiologic state during the surgical experience. Blood glucose monitoring in the operative environment may help the surgical team maintain safe blood glucose levels for the patient with diabetes and prevent postoperative fluid and electrolyte abnormalities. Intraoperative blood glucose monitoring by the circulating nurse has the potential to enhance the physiologic environment, health, and possible early discharge of the person with diabetes.