PAA's Aggressive Perioperative Glucose Control May Reduce Risk of Infection
03.20.2009
Presbyterian Anesthesia Associates' new aggressive protocol for managing the blood glucose levels of diabetics in the perioperative period is designed to reduce patients' risk of postoperative complications, including wound infections. The protocol was rolled out under the directorship of Sam Sayson, MD, the Chairman of PAA's Clinical Practice Committee (CPC), and in consultation with Presbyterian Endocrinology. The protocol has been successful in consistently reducing blood sugars below 200 mg/dl without a single episode of hypoglycemia.
Presbyterian Anesthesia Associates' new aggressive protocol for managing the blood glucose levels of diabetics in the perioperative period is designed to reduce patients' risk of postoperative complications, including wound infections. The protocol was rolled out under the directorship of Sam Sayson, MD, the Chairman of PAA's Clinical Practice Committee (CPC), and in consultation with Presbyterian Endocrinology. The protocol has been successful in consistently reducing blood sugars below 200 mg/dl without a single episode of hypoglycemia.
The incidence of surgical site infection (SSI) in the U.S. is 2-3%. This complication comes at great cost, both in terms of patient suffering and monetary expense. There is excellent evidence that better perioperative glucose control reduces postoperative wound infections in cardiac surgery patients, and overwhelming indirect evidence that some protection is proffered in other types of surgery. This represents the latest effort by PAA to work with our surgeons in reducing perioperative infection risk. The anesthesia department’s compliance with SCIP requirements for preoperative antibiotic administration approaches 100%. Additionally, we are already compliant with future PQRI initiatives on prevention and management of perioperative hypothermia. Our studies at Presbyterian Orthopaedic Hospital have helped define remedies for this clinical concern.
A summary of PAA’s efforts addressing SSI:
Potential benefits of even a 1% reduction in SSI rates:
Over the next few months the protocol will be initiated at every Presbyterian operative facility. We welcome any feedback from our surgeon colleagues.