San Francisco Plastic Surgery & Laser Center | Usha Rajagopal, MD

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Diabetes & Plastic Surgery

istock_diabetesWe all know now that smokers, and even homeopathic medicine devotees, can be at risk during surgery if they don’t follow proper protocol leading up to their procedure (see my earliest posts on these issues if this is news to you!)—but now it appears that diabetics can fall in this “at-risk” category as well. Most plastic surgeons don’t see a lot of patients with diabetic wounds, but when a wound has been stabilized and a patient is healthy enough to undergo surgery, plastic surgeons are sometimes consulted for wound closure to ensure minimal scarring—and in more serious cases, when a wound is advanced and amputation of an extremity is required, plastic surgeons are also usually called in to discuss reconstructive options.

A study released earlier this week found that that when patients undergo surgery for chronic wounds related to diabetes, their blood sugar levels can play an important role in how they heal. In fact, the study shows that the risk of serious wound complications is more than three times higher when patients have high blood glucose before and after surgery—and in patients who don’t have good long-term diabetes control.

This is mostly a concern for people who aren’t strict about monitoring their blood glucose levels, but the study’s authors were quick to point out that this issue can crop up for anyone with diabetes—even people who generally keep their blood sugar in check.

This study is the first to examine this particular issue with diabetic patients, so it’s not yet clear whether making a more concentrated effort to control blood glucose levels around the time of surgery will improve outcomes for diabetic patients. Doing so does, however, seem like a positive first step. And if you’re diabetic, this is one new area of study you’ll want to keep an eye on!