COMPARISON OF SURGICAL SITE INFECTIONS IN DIABETIC VERSUS NON-DIABETIC PATIENTS UNDERGOING CLEAN SURGICAL PROCEDURES AT A TERTIARY CARE HOSPITAL

MA KHAN; WY KHAN; MU DIN; MT FARMAN; J FARMAN; A FAROOQ

doi:10.54112/bcsrj.v2024i1.1124

Authors

MA KHAN Department of Surgery, Qazi Hussain Ahmed Medical Complex, Nowshera, Pakistan
WY KHAN Department of Surgery, Qazi Hussain Ahmed Medical Complex, Nowshera, Pakistan
MU DIN Department of Surgery, Qazi Hussain Ahmed Medical Complex, Nowshera, Pakistan
MT FARMAN Department of Surgery, Qazi Hussain Ahmed Medical Complex, Nowshera, Pakistan
J FARMAN Department of Obs & Gynae, Kulsoom Maternity Hospital, Peshawar, Pakistan
A FAROOQ Advance International Hospital, Islamabad, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.1124

Keywords:

Surgical Site Infections (SSIs), Diabetes, Complications

Abstract

Surgical site infections (SSIs) are a common complication that can significantly impact recovery, particularly in patients with diabetes. Understanding the incidence of SSIs in diabetic versus non-diabetic patients undergoing clean surgical procedures is critical for improving postoperative outcomes. Objective: This study aims to compare the incidence of surgical site infections (SSIs) in diabetic and non-diabetic patients undergoing clean surgical procedures at a tertiary care hospital. Methods: An observational cohort study was conducted with 110 patients, divided into two groups: Group A (diabetic patients) and Group B (non-diabetic patients). All patients underwent clean surgeries, including hernia repair and laparoscopic cholecystectomy. Postoperative complications, including SSIs, wound dehiscence, and seroma formation, were assessed. Statistical analysis was performed to evaluate differences in complication rates between the two groups, with a significance level set at p < 0.05. Results:

SSIs were observed in 10.9% of diabetic patients compared to 3.6% in non-diabetic patients, though this difference was not statistically significant (P = 0.14). Wound dehiscence occurred in 3.6% of diabetics versus 1.8% of non-diabetics (P = 0.55), while seroma formation was noted in 1.8% of diabetics, with no cases in the non-diabetic group (P = 0.31). Conclusion: The incidence of surgical site infections was higher in diabetic patients than in non-diabetic patients undergoing clean surgical procedures, though the difference was not statistically significant. Diabetic patients remain at an increased risk of postoperative complications, highlighting the need for enhanced perioperative care to mitigate infection risks.

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References

Ahuja S, Peiffer-Smadja N, Peven K, White M, Leather AJ, Singh S, et al. Use of feedback data to reduce surgical site infections and optimize antibiotic use in surgery: a systematic scoping review. Annals of surgery. 2022;275(2):e345-e52.

Zhou J, Wang R, Huo X, Xiong W, Kang L, Xue Y. Incidence of surgical site infection after spine surgery: a systematic review and meta-analysis. Spine. 2020;45(3):208-16.

Shiferaw WS, Aynalem YA, Akalu TY, Petrucka PM. Surgical site infection and its associated factors in Ethiopia: a systematic review and meta-analysis. BMC surgery. 2020;20:1-15.

Tariq A, Ali H, Zafar F, Sial A, Hameed K, Naveed S. A systemic review on surgical site infections: classification, risk factors, treatment complexities, economical and clinical scenarios. J Bioequiv Availab. 2017;9(1):336-40.

Burgess JL, Wyant WA, Abdo Abujamra B, Kirsner RS, Jozic I. Diabetic wound-healing science. Medicina. 2021;57(10):1072.

Martin ET, Kaye KS, Knott C, Nguyen H, Santarossa M, Evans R, et al. Diabetes and risk of surgical site infection: a systematic review and meta-analysis. Infection Control & Hospital Epidemiology. 2016;37(1):88-99.

Ismat U, Khan A, Nawaz A, Mansoor R, Malik AA, Sher F, et al. Surgical site infection in diabetic and non-diabetic patients undergoing laparoscopic cholecystectomy. J Coll Physicians Surg Pak [Internet]. 2016;26(2):100-2.

Qamar R, Mahmood K, Pervaiz N, Javed R, Sher F, Tufail I. Comparative Study on Incidence of Post-operative Wound Infection in Diabetic vs Non-diabetic Patients in Clean Surgical Procedure. Pakistan Journal of Medical Research. 2023;62(1):14-8.

Hwang JU, Son DW, Kang KT, Lee SH, Lee JS, Song GS, et al. Importance of hemoglobin A1c levels for the detection of post-surgical infection following single-level lumbar posterior fusion in patients with diabetes. Korean journal of neurotrauma. 2019;15(2):150-8.

Reich MS, Fernandez I, Mishra A, Kafchinski L, Adler A, Nguyen MP. Diabetic control predicts surgical site infection risk in orthopaedic trauma patients. Journal of orthopaedic trauma. 2019;33(10):514-7.

Valerius N, Eff C, Hansen N, Karle H, Nerup J, Søeberg B, et al. Neutrophil and lymphocyte function in patients with diabetes mellitus. Acta Medica Scandinavica. 1982;211(6):463-7.

Delamaire M, Maugendre D, Moreno M, Le Goff MC, Allannic H, Genetet B. Impaired leucocyte functions in diabetic patients. Diabetic Medicine. 1997;14(1):29-34.

Ganesh GV, Ramkumar KM. Macrophage mediation in normal and diabetic wound healing responses. Inflammation Research. 2020;69:347-63.

Holl J, Kowalewski C, Zimek Z, Fiedor P, Kaminski A, Oldak T, et al. Chronic diabetic wounds and their treatment with skin substitutes. Cells. 2021;10(3):655.

Armstrong DG, Tan T-W, Boulton AJ, Bus SA. Diabetic foot ulcers: a review. Jama. 2023;330(1):62-75.

Cheuk N, Worth L, Tatoulis J, Skillington P, Kyi M, Fourlanos S. The relationship between diabetes and surgical site infection following coronary artery bypass graft surgery in current-era models of care. Journal of Hospital Infection. 2021;116:47-52.

Beverly JK, Budoff MJ. Atherosclerosis: pathophysiology of insulin resistance, hyperglycemia, hyperlipidemia, and inflammation. Journal of diabetes. 2020;12(2):102-4.

Khalid M, Alkaabi J, Khan MA, Adem A. Insulin signal transduction perturbations in insulin resistance. International journal of molecular sciences. 2021;22(16):8590.

Arshad S, Rasul A, Batool M, Zukhruf Z, Asad MT. Diabetes and Risk of Surgical Site Infection: A Narrative Review. Journal of Health and Rehabilitation Research. 2024;4(1):567-72.