Appropriate glycemic control for prevention of surgical site infection (SSI) of colorectal surgery

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  • 大腸手術における手術部位感染（SSI）を予防する合理的な血糖コントロール

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Abstract

<p>Hyperglycemia after operation of colorectal surgery increased risk of surgical site infection (SSI). Though standard-ization of perioperative bundle for prevention of SSI was used in our institute since 1990, incidence rate of incisional SSI was rather high for diabetes (DM) patients. We started prospective study after 2000y trying more appropriate glycemic control for part of DM and impaired glucose tolerance (IGT) patients loading by continuous intravenous insulin infusion (CII). Setting the target of blood sugar (BS) level at 150mg/dL, we carefully observed and adjust-ed variation pattern of BS level until 48 hours using algorithm of BS control with receiving maintenance transfusion of 5％ or 7.5％ glucose concentration in order to prevent hypoglycemia as the management of risk control. Glycemic control using CII led to the small fluctuation range of BS, and there existed no hypoglycemic trouble in this trial. We obtained the improvement of rate of incisional SSI after 2000y for DM and IGT patients. 150mg/dL seemed more suitable for the target of BS level in general hospital. We again realized the importance of precise perioperative gly-cemic control for prevention of SSI of colorectal surgery.</p>

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