Surgical Site Infections After Foot and Ankle Surgery A comparison of patients with and without diabetes

OBJECTIVEdThis prospective study was designed to evaluate the rate of surgical site in-fection (SSI) after foot and ankle surgery in patients with and without diabetes. RESEARCH DESIGNANDMETHODSdThe study prospectively evaluated 1,465 con-secutive foot and ankle surgical cases performed by a single surgeon. RESULTSdThe overall SSI rate in this study was 3.5%, with significantly more infections occurring in individuals with diabetes than in those without (9.5 vs. 2.4%, P, 0.001). Peripheral neuropathy, Charcot neuroarthropathy, current or past smoking, and increasing length of sur-gery were significantly associated with SSI on multivariate analysis. CONCLUSIONSdThis study demonstrates significant associations between the develop-ment of SSI and chronic complications of diabetes. We confirm previous findings that it is peripheral neuropathy and not diabetes itself that most strongly determines the development of postoperative infections in these surgical patients. Diabetes Care 34:2211–2213, 2011 Surgical site infection (SSI) in patientswith diabetes leads to increased mor-bidity, mortality, length of stay, and health care costs. Patients with diabetes