Use of a postoperative insulin protocol decreases wound infection in diabetics undergoing lower extremity bypass

Journal of Vascular Surgery
Fuyuki HirashimaAndrew C Stanley

Abstract

Strict glucose control in patients undergoing coronary bypass grafting has been shown to decrease infectious complications, arrhythmias, and mortality. Our objective was to determine if strict glucose control reduced morbidity after lower extremity bypass (LEB). A prospective pilot study at a single institution within the Vascular Study Group of New England was conducted from January 2009 to December 2010. Patients with diabetes and without undergoing LEB were placed on an intravenous (IV) insulin infusion for 3 days after surgery with titration of blood glucose from 80 to 150 mg/dL. The IV insulin study group (n = 104) was compared to a historic control group (n = 189) that received standard insulin treatment from the preceding 3 years. The Fisher exact test, t-tests, Wilcoxon rank-sum tests, χ(2), and logistic regression analyses were used to compare in-hospital morbidity. Stratified analyses were conducted to determine if findings differed based on the presence or absence of diabetes. There was no difference in postoperative complications between the two groups with regard to graft infection, myocardial infarction, dysrhythmia, primary patency at discharge, or mortality. Patients in the IV insulin group had significantly few...Continue Reading

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Citations

Jul 31, 2016·Journal of Vascular Surgery·Edward A McGillicuddyLouis Nguyen
Apr 24, 2017·Journal of Vascular Surgery·Todd R VogelRobin L Kruse

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