Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

High blood sugar, obesity increase risk for surgical site infection

26.07.2012
Studies look at post-surgical infection after an orthopaedic trauma and total joint replacement
Two recent studies in the July issues of the Journal of Bone and Joint Surgery (JBJS) looked at surgical site infections and hyperglycemia, the technical term for high blood glucose, or high blood sugar. According to the first study "Relationship of Hyperglycemia and Surgical-Site Infection in Orthopaedic Surgery," high blood sugar is a concern during the post-traumatic and post-operative period and it may help to preoperatively identify a population of patients with musculoskeletal injuries who are at significant risk for infectious complications.

Nearly, one-third of patients who are admitted to the hospital without a history of diabetes have hyperglycemia, which is associated with a longer hospital stay, higher rates of admission to the intensive care unit (ICU), and increased mortality.

Study authors reviewed data on patients 18 years or older who had isolated orthopaedic injuries requiring acute operative intervention. Patients diagnosed with diabetes or who were in the ICU were not included in the study.

Of 790 patients, there were 268 open fractures (if the bone breaks in such a way that bone fragments stick out through the skin, or a wound penetrates down to the broken bone), and 21 surgical-site infections (SSIs) at 30-day follow-up. Age, race, comorbidities, injury severity, and blood transfusion were not associated with SSI at 30 days.
Specific study details: SSIs developed in 13 of 294 patients (4.4 percent) who had more than one glucose value greater than or equal to 200 mg/dL and 8 of 496 patients (1.6 percent) without more than one glucose value greater than or equal to 200 mg/dL. The authors concluded that hyperglycemia was an independent risk factor for thirty-day SSI in orthopaedic trauma patients without a history of diabetes.

This study suggests that recognition of the relationship between hyperglycemia and infectious complications may substantially influence post-operative care of orthopaedic patients. Large, prospective, randomized studies are necessary to further delineate this relationship.

A second study featured in the July 18 issue of JBJS, found that diabetes and morbid obesity increased the risk of infection following hip and knee replacement. Authors of "Obesity, Diabetes, and Preoperative Hyperglycemia as Predictors of Periprosthetic Joint Infection" analyzed 7,181 hip and knee replacements and found that 52 post-operative joint infections occurred within the first year, and that the infection rate increased from a .37 percent in patients with a normal body index to 4.66 percent in the morbidly obese group. Normal BMI was defined as a body mass index (BMI) of less than 25, while morbid obesity was defined as more than 40. (BMI is a calculation that is determined using height and weight).

Diabetes more than doubled the risk of a post-operative joint infection independent of obesity. The infection rate was the highest in morbidly obese, diabetic patients.

For patients without a diagnosis of diabetes at the time of surgery, there was a trend toward a higher infection rate in association with a pre-operative glucose level of more than 124 mg/dL.

The authors suggest that identifying and/or treating hyperglycemic patients preoperatively, especially if they are obese, would help patients achieve a better outcome by avoiding complications caused by infection. In addition, identifying patients with undiagnosed diabetes would be important for their overall long-term prognosis. Authors further conclude that the benefits of joint replacement should be carefully weighed against the incidence of postoperative infection, especially among the morbidly obese patients.

Full JBJS July 18 Table of Contents
A Multicenter Randomized Control Trial Comparing Single Row Fixation in Arthroscopic Cuff Repair

Suture Number Determines Strength of Rotator Cuff Repair

Spica Casting for Pediatric Femur Fractures: A Prospective, Randomized Controlled Study of Single-leg versus Double-leg Spica Casts

Reliability of predictors for Screw Cutout in Peritrochanteric Hip Fractures
The prognosis for Improvement in Comfort and Function after the Ream and Run Arthroplasty for Glenohumeral Arthritis

Evaluation of Muscle Size and Fatty Infiltration with MRI 9-11 years Following Hamstring Harvest for ACL reconstruction

Adverse Outcomes in Hip Arthroplasty: Long Term Trends

The Safety of Controlled Hyoptension for Shoulder Arthroscopy in the Beach Chair Position

Simple Guidelines for Efficient Referral of Soft Tissue Sarcomas: a population-based evaluation of adherence to guidelines and referral patterns

Selective Plantar Fascia Release for Non-healing Diabetic Plantar Ulcerations

A Clove-Hitch Suture Method for Small Caliber Tendon Ends
Arthroscopic Bankart Repair and Capsular Shift for Recurrent Anterior Shoulder Instability: Functional Outcomes and Identification of Risk Factors for Recurrence

The Benefits of Implant Removal from the Foot and Ankle

The Journal of Bone & Joint Surgery has been the most valued source of information for orthopaedic surgeons and researchers for over 100 years and is the gold standard in peer-reviewed scientific information in the field. JBJS is published twice a month online and in print. Abstracts are available online at (http://www.jbjs.org). Contact Michelle Hache for general information on JBJS at mhache@jbjs.org

A Nation in Motion

More than one in four Americans have bone or joint health problems, making them the greatest cause of lost work days in the U.S. When orthopaedic surgeons restore mobility and reduce pain, they help people get back to work and to independent, productive lives. Orthopaedic surgeons provide the best value in American medicine in both human and economic terms and access to high-quality orthopaedic care keeps this "Nation in Motion." To learn more, to read hundreds of patient stories or to submit your own story, visit anationinmotion.org

Lauren P Riley | EurekAlert!
Further information:
http://www.aaos.org

More articles from Health and Medicine:

nachricht Cholesterol-lowering drugs may fight infectious disease
22.08.2017 | Duke University

nachricht Once invincible superbug squashed by 'superteam' of antibiotics
22.08.2017 | University at Buffalo

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Fizzy soda water could be key to clean manufacture of flat wonder material: Graphene

Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.

As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...

Im Focus: Exotic quantum states made from light: Physicists create optical “wells” for a super-photon

Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.

Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...

Im Focus: Circular RNA linked to brain function

For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.

While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...

Im Focus: RAVAN CubeSat measures Earth's outgoing energy

An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.

The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...

Im Focus: Scientists shine new light on the “other high temperature superconductor”

A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.

Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Call for Papers – ICNFT 2018, 5th International Conference on New Forming Technology

16.08.2017 | Event News

Sustainability is the business model of tomorrow

04.08.2017 | Event News

Clash of Realities 2017: Registration now open. International Conference at TH Köln

26.07.2017 | Event News

 
Latest News

Cholesterol-lowering drugs may fight infectious disease

22.08.2017 | Health and Medicine

Meter-sized single-crystal graphene growth becomes possible

22.08.2017 | Materials Sciences

Repairing damaged hearts with self-healing heart cells

22.08.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>