The effect of intraoperative glycemic control on surgical site infections among diabetic patients undergoing coronary artery bypass graft (CABG) surgery

Abstract

Perioperative poor glycemic control in diabetic patients undergoing Coronary Artery Bypass Graft (CABG) surgery has been associated with infectious complications, particularly surgical site infections that are linked with adverse health surgical outcomes. The purpose of this study was to investigate the effect of two different intraoperative glycemic control protocol, tight and conventional, on thirty-day postoperative surgical site infection (SSI) rates among diabetic patients undergoing CABG surgery. Design: A randomized controlled trial (RCT) design was employed in the study, with a convenience sample of 144 adult patients who were scheduled to undergo coronary artery bypass grafting surgery. Setting: A main referral heart institute in Amman, Jordan. Participants: Subjects were randomly assigned to either the tight glycemic control group (n ¼ 72), which maintained an intraoperative blood glucose level of 110-149 mg/dl via continuous intravenous insulin infusion, or the conventional glycemic control group (n ¼ 72), which maintained an intraoperative blood glucose level of 150-180 mg/dl via continuous intravenous insulin infusion. The postoperative SSIs among both groups were evaluated and compared by independent blinded physicians. Results: The primary findings of this study indicated no statistically significant difference between the two treatment groups in terms of SSI rates and their potential adverse surgical outcomes (p ¼ 0.512). Conclusion: Nurses should consider the glycemic stability and glycemic control approach to minimize adverse surgical outcomes post CABG surgery. Healthcare providers should also carefully consider diabetic patients who have undergone CABG surgery and are at risk of developing postoperative SSIs. Clinicaltrials.gov identifier: NCT04451655 was retrospectively registered in 30/06/2020.

The connotation between perioperative glycemic control approach and sternal wound infection in individuals with diabetes mellitus experiencing cardiac surgery: A meta‐analysis

“…12 publications from a total of 2654 connected investigations that were examined that met the inclusion criteria and were published between 2004 and 2021 were chosen and included in the investigation 12,13,19‐28 . The results of these researches are presented in Table 2.…”

“…12 publications from a total of 2654 connected investigations that were examined that met the inclusion criteria and were published between 2004 and 2021 were chosen and included in the investigation. 12,13,[19][20][21][22][23][24][25][26][27][28] The results of these researches are presented in Table 2. 1564 individuals with DM and CS were in the chosen investigations' T A B L E 2 Characteristics of the selected investigations for the metaanalysis.…”

“…In investigations that were considered for the meta‐analysis, 1564 individuals with DM and CS were in the chosen investigations' starting point, 790 of them were using strict GC, and 774 were using moderate GC 12,13,19‐28 . Strict GC had significantly lower SWI compared with those with moderate GC in individuals with DM and CS.…”

“…In investigations that were considered for the meta-analysis, 1564 individuals with DM and CS were in the chosen investigations' starting point, 790 of them were using strict GC, and 774 were using moderate GC. 12,13,[19][20][21][22][23][24][25][26][27][28] Strict GC had significantly lower SWI compared with those with moderate GC in individuals with DM and CS. Although precautions must be exercised when dealing with its values because some of the selected investigations for this meta-analysis were with a low sample size (4 out of 12 were ≤ 100 individuals).…”

Risk factors of wound infection after lung transplantation: a narrative review

“…Diabetes is a risk factor for incision infection after esophagectomy and orthopedic surgery. It also plays a significant role in causing incision infection in lung transplantation patients after surgery (28)(29)(30). The incidence of type 2 diabetes was significantly higher in lung transplant patients with SSI than in patients without SSI, according to a retrospective study (47.3% vs. 0.9%) (31).…”