<< Back to the abstract archive
Risk of Postoperative Infection Following Carpal Tunnel Release in Patients with Diabetes Mellitus: A Review of 658 Surgeries
Samantha Zwiebel, Devra Becker
University Hospitals Case Medical Center
2014-03-15
Presenter: Samantha Zwiebel
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. Please make a statement as to how much of the above work represents the original work of the resident.
Director Name: Hooman Soltanian
Author Category: Medical Student
Presentation Category: Clinical
Background: The perioperative management of patients with diabetes mellitus (DM) is informed by the perceived risk of infection, but questions remain about the risk of surgical site infection (SSI) in carpal tunnel release (CTR), a sequelae of DM.
Methods: Charts of patients undergoing CTR from January 2002 to September 2012 at the LSCVAMC were reviewed for SSI. Infection was defined as any wound requiring non-prophylactic antibiotics. Progress notes of all patients who received antibiotics perioperatively were reviewed for indication. Age, sex, diabetic status, and HbA1c were additional data points.
Results: 528 patients underwent 658 surgeries. 260 (35.1%) cases were diabetic, 92.2% were male, and mean age was 62.2 years. 177 (26.9%) cases received perioperative antibiotics: 88 (49.7%) received antibiotics as prophylaxis and 27 (15.3%) for SSI. Cases that received prophylactic antibiotics included 57 diabetic and 31 non-diabetic. Of patients with SSI, 8 (29.6%) were diabetic versus 19 (70.4%) non-diabetic (p>0.05). 3.1% of diabetic and 4.8% of non-diabetic patients experienced SSI (p>0.05). When patients with prophylactic antibiotics were excluded, 3.8% of diabetic and 4.9% of non-diabetic patients experienced SSI (p>0.05). Incidence of infection in diabetic patients was not significantly lower in patients on prophylactic antibiotics. Diabetic patients with HbA1c ≥7% did not have significantly different risk of SSI compared to those with HbA1c <7%.
Conclusions: No significant differences were observed in the incidence of SSI following CTR in diabetic versus non-diabetic patients with or without prophylactic antibiotics. Strict glycemic control does not reduce risk of SSI.
