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March 2011

Stratification of Patients Who Underwent Colorectal Surgery: Determining the Risk of Surgical Site Infection Related to Postoperative Hyperglycemia

Author Affiliations

Author Affiliations: Second Department of Propedeutic Surgery, Medical School, University of Athens, General Hospital Laiko, Athens, Greece.

Arch Surg. 2011;146(3):369. doi:10.1001/archsurg.2011.17

Ata et al1 have unveiled an interesting association between postoperative hyperglycemia and surgical site infection (SSI) that may significantly influence surgical practice in terms of the patient's health and the cost of care. There have been studies of diabetic and nondiabetic patients who underwent cardiac surgery and of patients in intensive care units, and these studies have implemented perioperative antibiotic prophylaxis, which has been documented to dramatically reduce the incidence of postoperative SSI. With special regard to the subgroup of patients who underwent colorectal surgery, a combined oral and intravenous antibiotic regimen seems to be more effective than an oral or intravenous prophylaxis regimen alone, achieving a risk reduction of at least 75%.2 Moreover, the risk of SSI in patients who underwent colorectal surgery varies depending on the type of colorectal surgery (ie, right colon, left colon, or rectal surgery) and the level of colon resection and anastomosis, with left colon surgery and rectal surgery exhibiting higher rates of SSI owing to their different microbial flora.3 A significant reduction in SSI rates has also been shown for patients who underwent laparoscopic colorectal procedures compared with patients who underwent open surgery.4

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