Our Summary

This research paper is examining if there is a connection between diabetes and the rate of complications after elective hand surgery. The researchers looked at medical records of patients who had elective hand, forearm, or elbow surgery over the span of 10 years. They then divided these patients into two groups: those with diabetes and those without. They also recorded the patients’ HbA1c levels, a measure of blood sugar control. They then compared the rate of surgical complications within 30 days between the two groups.

The study found that there was no significant difference in the rates of complications between the patients with diabetes and those without. They also found no difference in complication rates between diabetics who controlled their disease with insulin and those who didn’t. The researchers also found that there was no increased risk of complications with higher HbA1c levels.

In simpler terms, the study found that having diabetes does not increase the risk of complications after elective hand surgery. Also, how well a patient’s diabetes is controlled, as measured by HbA1c levels, does not affect the risk of complications.

FAQs

  1. Does having diabetes increase the risk of complications after elective hand surgery?
  2. Does the level of blood sugar control, measured by HbA1c levels, affect the risk of complications after hand surgery?
  3. Is there a difference in complication rates between diabetics who control their disease with insulin and those who do not?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hand surgery is to follow all pre-operative and post-operative instructions provided by the surgeon. This may include avoiding certain medications, fasting before surgery, and properly caring for the surgical site after the procedure. Following these instructions can help optimize the healing process and reduce the risk of complications.

Suitable For

Patients who are typically recommended for hand surgery include those with conditions such as carpal tunnel syndrome, trigger finger, arthritis, tendonitis, fractures, nerve compression, congenital abnormalities, or other hand injuries. These patients may experience pain, limited mobility, weakness, numbness, or other symptoms that affect their daily activities and quality of life. Hand surgery can help improve function, relieve pain, and restore hand strength and dexterity in these patients.

Timeline

Before hand surgery:

  1. Patient consults with a hand surgeon to discuss the need for surgery and potential risks and benefits.
  2. Patient undergoes pre-operative testing, such as blood work and imaging, to ensure they are healthy enough for surgery.
  3. Patient may be advised to stop taking certain medications, such as blood thinners, in the days leading up to surgery.
  4. Patient receives instructions on how to prepare for surgery, including fasting before the procedure.
  5. Patient undergoes hand surgery, which may involve repairing tendons, nerves, or bones in the hand, forearm, or elbow.

After hand surgery:

  1. Patient wakes up in the recovery room and is monitored for any immediate complications.
  2. Patient may be given pain medication to manage discomfort after surgery.
  3. Patient undergoes physical therapy to regain strength and mobility in the hand.
  4. Patient follows a post-operative care plan, which may include keeping the hand elevated, changing dressings, and attending follow-up appointments.
  5. Patient may experience swelling, bruising, and stiffness in the hand as it heals.
  6. Patient gradually resumes normal activities and work, following the guidance of their hand surgeon and physical therapist.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hand surgery, especially if they have diabetes, include:

  1. What specific risks or complications are associated with hand surgery for someone with diabetes?
  2. Will my diabetes and blood sugar levels impact the success of the surgery or my recovery process?
  3. Are there any special precautions or considerations that need to be taken before, during, or after the surgery due to my diabetes?
  4. How will my diabetes medication or insulin regimen be managed before and after the surgery?
  5. How can I best prepare for surgery to ensure the best possible outcome, given my diabetes diagnosis?
  6. Are there any lifestyle changes or additional medical monitoring that I should consider post-surgery due to my diabetes?
  7. Are there any specific signs or symptoms I should watch for post-surgery that may indicate a complication related to my diabetes?
  8. Will my diabetes diagnosis impact the type of anesthesia used during the surgery or my pain management plan?
  9. What is the overall success rate for hand surgery in patients with diabetes, and what factors contribute to that success?
  10. Are there any alternative treatment options or modifications to consider for hand surgery in someone with diabetes?

Reference

Authors: Del Core MA, Benage TC, Ahn J, Koehler D, Sammer D, Golden AS. Journal: J Hand Surg Asian Pac Vol. 2021 Dec;26(4):618-624. doi: 10.1142/S2424835521500594. PMID: 34789119