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Perioperative Glucose Monitoring and Treatment to Reduce Risk of Surgical Site Infections & Postoperative Complications
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2025-05
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Patients with Type 2 Diabetes are at a higher risk of delayed wound healing, development of surgical site infections, and other surgical complications due to hyperglycemia and insulin resistance (Harris, 2018). However, variations in perioperative glucose control can translate to an even more significant risk in non-diabetic patients. A quantitative quasi-experimental research study was developed aimed at determining how the implementation of a perioperative glucose monitoring and treatment protocol for hyperglycemia improves surgical patient 30-day outcomes. The goal of the protocol was to keep perioperative blood glucose below the Centers for Disease Control and Prevention’s (CDC) guideline of 200mg/dL. Retrospective cohort analysis revealed a strong positive correlation between the length of surgery and the incidence of perioperative hyperglycemia; therefore, procedure duration lasting over two hours was an inclusion criterion for the study. Participants were monitored for hyperglycemia and treated with sliding-scale insulin lispro using existing hospital-based hyperglycemia protocols structured on the preoperative Hemoglobin A1C (HgbA1c) regardless of diabetes diagnosis. Data collection included participant demographics, surgical duration, preoperative A1C, perioperative glucose readings, insulin dosing, and 30-day postop Comprehensive Complication Index (CCI). Results showed that no episodes of hypoglycemia occurred in the study, even with the inclusion of non diabetic patients, as insulin dosing was patient-specific, and patients were not treated for blood glucose elevations below 150 mg/dL. There was a statistically significant association between monitoring and treating perioperative hyperglycemia with decreased incidence in surgical site infections (SSI) in the pilot study [x² (1) =4.18, p = 0.041]. There was a decrease in the rate of SSI (9.76%) in the POGM group compared to the no-treatment group (21.1%).