Patient selection: diabetic undergoing colorectal resection (segmental colectomy, total proctocolectomy, anterior resection, abdominal perineal resection)
Risk factors for surgical site infection on multivariate analysis:
(1) excessive hyperglycemia
(2) placement of one or more surgical drains
(3) therapy with prophylactic antibiotics > 24 hours
where:
• "Prophylactic" antibiotics for > 24 hours raises the possibility of mislabeling (the surgeon is actually trying to treat an infection).
• Drains may be placed more often if there is an increased risk for infection.
• The sample for glucose measurement (whole blood vs plasma/serum) was not stated.
Control of hyperglycemia was important in preventing SSI. Goals for glucose control:
(1) < 185 mg/dL at 0 to 6 hours after surgery
(2) tight control afterwards (< 160 mg/dL)
(3) avoid hypoglycemia
Stoma creation was a risk factors identified on univariate analysis.
