Influence of Glycemic Control on Bacterial Surgical Site Infection Rates In General Surgery Patients

Abstract

Background: Surgical site infection is one of the common postoperative complications in general surgery and is associated with delayed wound healing, prolonged hospital stay and increased healthcare cost. A poor glycemic control is an important patient-related risk factor that can lead to impaired wound healing and immune response and, consequently, to postoperative bacterial infection.

Objective: To determine the influence of glycemic control on bacterial surgical site infection rates among general surgery patients.

Methods: The descriptive cross sectional study was done in the Department of General Surgery, Lady Reading Hospital, Peshawar from January 2025 to June 2025. The number of patients was 83 from a non-probability consecutive sampling of general surgery patients. A structured proforma was used to record the following demographic details: clinical history, glycemic profile, surgical characteristics and postoperative wound findings. Glycemic control was assessed using HbA1c, fasting blood glucose and random blood glucose levels. Patients with HbA1c level < 7% were considered to have good glycemic control and those with HbA1c level ≥ 7% were considered to have poor glycemic control. Surgical site infection was diagnosed clinically and if infection was suspected, wound samples were sent for bacterial culture. SPSS was used for data analyses, and a p-value < 0.05 was set as statistically significant.

Results: Out of 83 patients, 47 (56.6%) had good glycemic control and 36 (43.4%) had poor glycemic control. Surgical site infection was observed in 19 (22.9%) patients. The SSI rate was significantly higher among patients with poor glycemic control compared with patients having good glycemic control, 38.9% versus 10.6%, respectively (p=0.003). Culture-positive bacterial SSI was also more frequent in the poor glycemic control group, 33.3% versus 8.5% (p=0.005). Staphylococcus aureus was the most common bacterial isolate, followed by Escherichia coli and Klebsiella species. Patients with SSI had a longer mean hospital stay compared with those without infection.

Conclusion: Poor glycemic control was significantly associated with increased bacterial surgical site infection rates in general surgery patients. Preoperative assessment of glycemic status and strict perioperative glucose monitoring may help reduce bacterial SSI and improve postoperative recovery.