Comparative Study on Incidence of Post-operative Wound Infection in Diabetic vs Non-diabetic Patients in Clean Surgical Procedure

Abstract

Background: Diabetes mellitus is associated with a theoretical increase in risk of development of post-operative infections; however, literature on the subject is conflicted, with some studies negating the effect of high blood sugar on the development of surgical wound site complications.Objectives: To compare the complications of ventral hernia repair in diabetics versus non-diabetics in terms of frequency of surgical site infection, seroma and haematoma formationStudy type,settings& duration:A prospective cohort study conducted Department of General Surgery, Combined Military Hospital,Rawalpindi from November 2019 to December2020.Methodology:Atotal of 182 patients (91 in each group) diagnosed with a ventral abdominal hernia who met the sample selection criteria were included. Patients who were diabetic were placed in Group A, while Group B patients were non-diabetic. All patients were followed up for surgical site infection, seroma and haematoma formation. Data was analyzed using SPSS 26.0.Results:The mean age of patients was 46.54±10.58 years (range 25-70 years). The patients included 113 females (62.1%) and 69 males (37.9%). A total of9 (9.9%) patients developed surgical site infections in Group A versus 2 (2.2%) in Group B, (p=0.029). Seroma formation was seen in 4 (4.4%) patients of Group A versus 2 (2.2%) Group B patients, p=0.406. One(1.1%) case from each group developed haematomas, (p=1.000).The relative riskratios in diabetics for developing surgical site infections, seromas and haematomas were RR: 4.9 (CI 95% 1.03 –23.3), RR: 2.1 (CI 95% 0.37 –11.5) and RR: 1.0 (CI 95% 0.06–16.2).Conclusion:Diabetics are prone to increased rates of surgical site infection, even in clean surgeries, when compared to non-diabetics, but there was no difference in frequencies of other complications.

Keywords

• diabetes mellitus
• surgical site infection
• ventral hernia repair