How To Achieve A Better Outcome

To General Surgery As A Diabetic

By Dr. Katherine A. Sahm, M.D., F.A.C.S. 

In addition to known and common risks of general surgery: e.g. gallbladder removal, hernia repair, wound treatment, breast surgery, or any incision and drainage procedure to name a few, diabetics have an increased risk of surgical complications.

If you have had diabetes for an extended period of time or if you have frequently high blood sugars and are difficult to control your glucose level on a daily basis prior to surgery your risk increases. If you are a patient who has experienced complications in your life from diabetes such as neuropathy (decreased to no feeling in your lower extremities or legs and feet) or if you have had an amputation of your lower extremities you are at higher risk.

Risks Diabetics May Face after Surgery:

Poor or slow wound healing (incision line)

Weak skin and tissue at the surgical site

Infection of the wound

High Blood Glucose Levels or Low Blood Glucose Levels

Other types of Infection such as pneumonia or urinary tract infections

What Can You Do to Improve Your Surgical Outcomes if you are a Diabetic?

Planned surgeries or elective surgeries usually provide a period of time where a diabetic can hone in and be diligent regarding blood sugar management over a period of time prior to surgery. Ideally a diabetic should have good control for three months prior to an elective surgery. It is the emergency surgeries that require a diabetic to be diligent at all times regarding controlling their blood sugars. Better control of your diabetes will better your chances of a positive surgical outcome. This includes keeping your blood sugars in the parameters that were provided by your treating physician with regular monitoring.

Prior to any scheduled surgery if you take diabetes medications  such as metformin or insulin notify your surgeon. They may wish for you to obtain blood work to determine your blood sugar levels prior to your surgery.

People with diabetes are more likely to have poor circulation, nerve damage, and weakened immune systems. They also can have skin problems. This can slow wound healing and increase the risk of infection.

Incision infection and non-healing is a risk because of slower healing time with diabetics. It is very important to take all medications as ordered after surgery and follow the discharge instructions  after your surgery regarding incision care to avoid infection.

Proper nutrition including protein is a must and may contribute to improved wound and incision healing. Protein can allow for stronger tissue at the surgical site. If your renal (kidney) function has been affected by your diabetes you must check with your treating physician regarding protein intake.

Additionally, exercise can make your body stronger which is going to help you better tolerate surgery and recovery. Please check with your doctor prior to starting any exercise program.

Following your surgery it will be important that you work with your primary care team to be certain that your sugars remain under control and within the parameters defined by your primary care physician.

Bio

Dr. Katherine Sahm is a general surgeon and treats various patients with diabetes who are in need of general surgical procedures and wound care on a regular basis. If you wish to set up an appointment with Dr. Sahm please call 302-475-4900 or visit christianacare.org/surgery. Her office is located at 1401 Foulk Road, Suite 207 in Foulk Stone Plaza in Wilmington, DE.