Outpatient Surgery Magazine

Post Your Prices Online - September 2013 - Outpatient Surgery Magazine - Subscribe

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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OSE_1309_part3_Layout 1 9/6/13 12:21 PM Page 142 INFECTION PREVENTION Ron Olson, MD Reducing SSIs in Diabetics Glucose control is just one part of a much bigger picture. W e know surgical site infections are common in diabetic patients, and even more common in patients (known diabetics and others) with higher pre-operative glucose and BALANCING ACT Using insulin to lower glucose levels can decrease some risks while simultaneously increasing others. hemoglobin A1C levels. Insulin normalizes glucose and also has anti-inflammatory benefits that are known to reduce SSIs in diabetics and non-diabetics. So you'd probably assume that using pre-operative insulin infusions to reduce glucose levels would reduce the risk of SSIs and overall morbidity. Not necessarily. While it's true that high glucose produces an environment that interferes with healing and predisposes patients to infections, it's likely that many of the SSIs suffered by diabetics come from secondary conditions, such as neuropathy and microcirculatory deficits. And those are conditions that can't be changed quickly. In addition, stress increases glucose levels, so high glucose may be as much a marker of increased perioperative risk as a cause of it. Complicating matters further is the fact that while high glucose is bad, so is low glucose. You may reduce some risks by lowering glucose levels, but 1 4 2 O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | S E P T E M B E R 2013

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