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March 2011

Hyperglycemia and Surgical Site Infection: Not Ready for Prime Time—Reply

Author Affiliations

Author Affiliations: Department of Surgery, Albany Medical College, Albany, New York.

Arch Surg. 2011;146(3):370. doi:10.1001/archsurg.2011.19

In reply

We appreciate the feedback and critique of our article from surgeons across the globe. Although there are meta-analyses revealing no reduction in infectious complications using mechanical bowel preparation, all patients in the current series who underwent elective colorectal resections received a mechanical bowel preparation and prophylactic intravenous antibiotics (cefazolin sodium and metronidazole benzoate).1,2 The series did include emergency operations for patients who did not receive a bowel preparation or oral antibiotics but who did receive intravenous broad-spectrum antibiotics. Multivariate adjustment for the degree of contamination and the effect of the laparoscopic technique was not performed owing to the small number of patients who underwent colorectal surgery. We have acknowledged that the reason that the postoperative serum glucose level was the only significant risk factor in bivariate and multivariate analyses of patients who underwent colorectal surgery might be the number of patients in our study sample.

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