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

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.