Glucose control in the post-operative period : surgical site infections in diabetes mellitus

Abstract

Topic overview: Diabetes Mellitus is one of the leading causes of disabilities, diminished quality of life and is highly prevalent. By undergoing a surgical procedure, diabetics have an increased risk in developing SSI during the post-operative period, therefore in order to avoid the occurrence of SSI and further complications adequate glucose control measures are required. Research Question: Does glucose control during the Post-Operative period reduce surgical site infection amongst adults suffering from Diabetes? PICO Elements: The population studied comprised of adults suffering from DM. The intervention being reviewed was glucose control during post-operative period during the hospital stay. The comparison was between the blood glucose levels. The expected outcome was a reduced occurrence of SSI. Methods: Various search terms were identified and then combined with limiters and search tools in order to create a specific search strategy for each database. Hydi, PubMed, ProQuest and EBSO were the databases used to carry out the searches. The flow diagram PRISMA was used for screening articles. Inclusion and exclusion criteria were applied to specify the selection of key studies. The inclusion criteria being articles published after 2010 and articles published only in English, whilst the exclusion criteria being articles published in other languages instead of English and articles focusing on patients who do not suffer from DM. A systematic review and Cohort studies were eligible, which had to be published in the past ten years (since 2010) and written in English. The CASP tool was used to critically appraise the studies chosen. Results: The key studies consisted of one systematic review and four retrospective cohort studies. The results of the studies did identify that glucose control does help in the reduction of surgical site infections; however, a specific blood glucose level was not identified as each study consisted of a different value. Various limitations were identified. Implications and Recommendations: Recommendations for further research include having more local research, using larger sample sizes, and extending the follow-up periods. Implementation of local staff training to raise awareness should also be implemented.