Association of Pre-Operative Glycaemic Control with Surgical Site Infection Following Orthopaedic Implant Surgery

Abstract

Background: Poor preoperative glycaemic control may increase the risk of surgical site infection (SSI) following orthopaedic implant surgery. This study aimed to assess the association between preoperative glycaemic parameters and SSI.

Materials and Methods: This prospective observational study included 140 patients undergoing orthopaedic implant surgery. Patients were categorized as non-diabetic (n=60), diabetic with adequate glycaemic control (n=40), and diabetic with inadequate glycaemic control (n=40). Preoperative HbA1c, fasting blood glucose, and postprandial blood glucose levels were assessed and correlated with postoperative SSI.

Results: SSI occurred in 18 (12.9%) patients, with infection rates of 5.0%, 10.0%, and 27.5% across the three groups, respectively. Mean HbA1c was higher among patients with SSI than those without infection (8.1 ± 1.6% versus 6.4 ± 1.4%). HbA1c showed the strongest positive correlation with SSI (r=0.382), followed by fasting (r=0.326) and postprandial blood glucose (r=0.294).

Conclusion: Inadequate preoperative glycaemic control was associated with increased SSI following orthopaedic implant surgery. Glycaemic optimization and perioperative monitoring may help reduce postoperative infections.