Dynamic control and timely correction of blood glucose levels in diabetic patients undergoing traumatic spinal vertebral fracture surgery to reduce surgery site infection

Objectives

This study was designed to clarify the impact of precise and dynamic control and timely correction of accurate blood sugar control in reducing the rate of post-spinal fracture surgery infections in impaired glucose tolerance or diabetic patients by posterior approach.

Methods

In this single-blinded clinical trial, a total of 290 patients with diabetes or impaired glucose tolerance candidate for traumatic spinal vertebral fracture by posterior approach (PSF) were randomly assigned to either a blood glucose control group (n = 145) or a control group (n = 145). The blood glucose control group received precise control of blood sugar levels before, during, and after surgery, while the control group did not. The incidence of SSI was compared between the two groups at one- and six months post-surgery using statistical tests and SPSS software version 22.

Results

Based on intergroup comparisons, the rate of infection at the site of surgery one month after spinal vertebral fracture surgery (PSF) in patients in the blood glucose control group was significantly higher than the control group (P < 0.05, 4.8%, and 11.7%). There was no significant difference between the rate of infection in the surgical site six months after spinal vertebral fracture surgery (PSF) in patients of the two groups studied (P > 0.05, 4.1%, and 4.8%). According to intragroup comparisons, there was no significant difference between the infection rate of the surgical site one month and six months after spinal vertebral fracture surgery in the patients of the blood sugar control group (P > 0.05). In patients in the control group, the infection rate at the surgery site of surgery 6 months after surgery was significantly lower than at the site of surgery one month after surgery (P < 0.05). Logistic multivariate regression analysis revealed that malnutrition variables, malignancy, duration of stay in the ICU after surgery, and blood sugar correction intervention statistically correctly contributed significantly to the classification of patients with infection and predicted the incidence of infection in Patients (P < 0.05).

Conclusion

Accurate and timely blood sugar control before, during, and after spinal vertebral fracture surgery by posterior approach is crucial in reducing the risk of SSI in diabetic or impaired glucose tolerance patients. The study highlights the importance of both dynamic control and timely correction of blood glucose levels, not only in the early postoperative period but also in preventing later infectious complications.