The Relationship Between Preoperative Glycosylated Hemoglobin Levels and Postoperative Wound Complications in Diabetic Patients Undergoing Hysterectomy

Year 2024, , 59 - 68, 09.06.2024

Kübra Dilbaz , Ezgi Arabacı , Eylem Ünlübilgin , Fulya Kayıkçıoğlu , Sevgi Koç , Tuğba Kınay , Yaprak Engin Üstün

https://doi.org/10.46969/EZH.1478530

Abstract

Objective: The aim of this study is to investigate whether there is a relationship between glycosylated hemoglobin (HbA1c) and wound complications in diabetic women who have undergone hysterectomy for benign reasons.
Material and Methods: Our retrospective observational study included 153 patients with diabetes mellitus and 154 women without diabetes mellitus who underwent total abdominal (open) hysterectomy for benign reasons at the Gynecology Clinic of Health Sciences University Etlik Zübeyde Hanım Women’s Diseases Training and Research Hospital between January 2016 and November 2022. The HbA1c level and the preoperative fasting blood glucose level were evaluated in 2 groups as patients with and without wound complication. These values were compared with the significance of the results of complications at the wound site.
Results: The study included 307 patients who underwent hysterectomy. All patients underwent open hysterectomy and preoperative 2 g of cefazolin was administered intravenously prophylactically. When the presence of comorbidities (comorbidities other than diabetes mellitus) was analyzed to assess the general health of the patients, a significant difference was found between the groups (p<0.001). 42.2% of patients in the control group and 99.3% of patients in the study group had a diagnosis for a comorbid condition. The HbA1c level and fasting blood glucose level before surgery were not statistically significant in distinguishing wound complications (p=0.588 and p=0.967, respectively). The postoperative 1st day White blood cell (WBC) count was higher in the study group than the control (12611.38±3287.71 vs. 11075.18±3032.68, p 0.013).
Conclusion: In our study, no significant association was found between HbA1c levels and wound complications in patients undergoing hysterectomy for benign reasons. However, it was found that the postoperative 1st day WBC count had predictive value for the wound complication in this population.

Keywords

Glycosylated haemoglobin (HbA1c), blood glucose level, hysterectomy, surgical site infection

Ethical Statement

The present study was approved by the Ethics Committee for Noninterventional Studies of Etlik Zubeyde Hanim Women Health Education Research Hospital on December 26, 2022, with approval number 16.

Supporting Institution

The study did not receive funding.

Histerektomi Operasyonu Geçiren Diyabetik Hastalarda Preoperatif Glikolize Hemoglobin Seviyesi ile Postoperatif Yara Yeri Komplikasyonları Arasındaki İlişki

Abstract

Amaç: Bu çalışmanın amacı, benign nedenlerle histerektomi geçiren diyabetik kadınlarda glikolize hemoglobin (HbA1c) ile yara komplikasyonları arasında bir ilişki olup olmadığını araştırmaktır.
Gereç ve Yöntemler: Retrospektif gözlemsel çalışmamıza Ocak 2016- Kasım 2022 tarihleri arasında Sağlık Bilimleri Üniversitesi Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim Araştırma Hastanesi jinekoloji kliniğinde benign nedenler ile total abdominal (açık) histerektomi yapılan ve diabetes mellitus tanısı olan 153 hasta çalışma grubu, diabetes mellitus tanısı olmayan 154 hasta kontrol grubu olarak dahil edilmiştir. HbA1c düzeyi ve ameliyat öncesi açlık kan şekeri düzeyi, yara komplikasyonu olan ve olmayan hastalar olarak 2 grupta değerlendirildi. Bu değerler yara yerindeki komplikasyonların sonuçlarının anlamlılığı ile karşılaştırıldı.
Bulgular: Çalışmaya histerektomi yapılan 307 hasta dahil edildi. Tüm hastalara açık histerektomi yapıldı ve ameliyat öncesi profilaktik olarak 2 g sefazolin intravenöz olarak uygulandı. Hastaların genel sağlığını değerlendirmek için komorbidite (diabetes mellitus dışındaki komorbiditeler) varlığı analiz edildiğinde, gruplar arasında anlamlı bir fark bulundu (p<0.001). Kontrol grubundaki hastaların %42,2’si ve çalışma grubundaki hastaların %99,3’ü komorbid bir durum için tanı almıştır. Ameliyat öncesi HbA1c düzeyi ve açlık kan şekeri düzeyi yara komplikasyonlarını ayırt etmede istatistiksel olarak anlamlı değildi (sırasıyla p=0.588 ve p=0.967). Ameliyat sonrası 1. gün beyaz kan hücresi (BK) sayısı çalışma grubunda kontrol grubuna göre daha yüksekti (12611.38±3287.71 vs. 11075.18±3032.68, p 0.013).
Sonuç: Çalışmamızda, benign nedenlerle histerektomi yapılan hastalarda HbA1c düzeyleri ile yara komplikasyonları arasında anlamlı bir ilişki bulunmamıştır. Bununla birlikte, postoperatif 1. gün WBC sayısının bu popülasyonda yara komplikasyonu için prediktif değeri olduğu bulunmuştur.

Keywords

Glikolize hemoglobin (HbA1c), kan şekeri düzeyi, histerektomi, cerrahi alan enfeksiyonu

Ethical Statement

Mevcut çalışma Etlik Zübeyde Hanım Kadın Sağlığı Eğitim Araştırma Hastanesi Girişimsel Olmayan Çalışmalar Etik Kurulu tarafından 26 Aralık 2022 tarihinde 16 onay numarası ile onaylandı.

Supporting Institution

Çalışma finansman almadı

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