Diabetic Control Predicts Surgical Site Infection Risk in Orthopaedic Trauma Patients

Michael S. Reich, Isaac Fernandez, Abhinav Mishra, Lisa Kafchinski, Adam Adler, Mai P. Nguyen

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Objectives:(1) To determine the incidence of surgical site infections (SSIs) in diabetic orthopaedic trauma patients and (2) to establish a protocol for managing diabetes mellitus (DM) in orthopaedic trauma patients.Design:Retrospective cohort study.Setting:Level 1 Trauma Center.Patients:All diabetic orthopaedic trauma patients who underwent surgical intervention with at least 1 month follow-up. Patients were classified as poorly controlled or controlled diabetic patients based on admission hemoglobin A1c and blood glucose (BG) levels.Interventions:Orthopaedic surgical intervention in accordance with fracture type and a standardized diabetes management protocol with internal medicine comanagement.Main Outcome Measurement:SSI incidence.Results:There were 260 patients during the study period. Two hundred two (77.7%) were included in the final analysis. Seventy-five (37.1%) patients met the criteria for poorly controlled DM. The overall rate of SSI was 20.8%; 32.0% for poorly controlled diabetic patients, and 14.2% for controlled diabetic patients (P < 0.01). The admission blood glucose level (BG, P = 0.05), but not discharge BG, was associated with SSI incidence.Conclusions:Trauma patients with poorly controlled DM have a higher rate of SSIs than patients with controlled DM. Perioperative diabetes control does not seem to decrease infection rates in these patients.Level of Evidence:Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Original languageEnglish (US)
Pages (from-to)514-517
Number of pages4
JournalJournal of orthopaedic trauma
Issue number10
StatePublished - Oct 1 2019

Bibliographical note

Publisher Copyright:
Copyright © 2019 Wolters Kluwer Health, Inc.

Copyright 2020 Elsevier B.V., All rights reserved.


  • diabetes mellitus
  • orthopaedic trauma
  • surgical site infection


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