0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Invited Critique |

Role of Hyperglycemia in SSIs: Postoperative Hyperglycemia and SSI in General Surgery Patients Comment on “Postoperative Hyperglycemia and Surgical Site Infection in General Surgery Patients”

Joseph H. Frankhouse, MD
Arch Surg. 2010;145(9):864. doi:10.1001/archsurg.2010.161.
Text Size: A A A
Published online

Extract

Diabetes mellitus has been thought to represent a risk factor for several types of surgical complications, as well as SSI, but is perceived to be beyond our control. The article by Ata et al dispels the notion that diabetes gives us risk we cannot manage and adds to the recent literature1 that suggests that hyperglycemia is the issue to be controlled to reduce SSI rates.

However, various shortcomings need to be addressed as the science of understanding and controlling SSI proceeds. First, this article shows an association, not causation, between postoperative hyperglycemia and SSI. Striking is the failure to find the association in vascular surgery patients, who presumably have the highest rates of diabetes and had higher rates of SSI than did general and colorectal surgery patients. This leads one to wonder whether factors such as hemoglobin A1C level, nutrition, tobacco use, obesity, operative time, and tissue perfusion/oxygenation may be more powerful factors in the equation. Efforts are also under way to culture postoperative infections to understand whether current prophylaxis is inadequate for today's bacteria.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

123 Views
3 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com

Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed
How Can I Apply the Results to Patient Care?

Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed
Has the Information From the Study Addressed Aspects of Life That Your Patient Considers Important?

brightcove.createExperiences();