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Undetected diabetes and the plastic surgeon
1Division of Plastic Surgery, Mt. Sinai Medical Center, Cleveland, Ohio.
Plastic and Reconstructive Surgery
|September 1, 1990
Summary
Undetected diabetes mellitus can cause rare but serious plastic surgery complications. Screening for diabetic tendencies, even with normal tests, is crucial for patient safety and optimal surgical outcomes.
Area of Science:
- Plastic Surgery
- Endocrinology
- Immunology
Background:
- Plastic surgery patients are typically healthy, making major postoperative complications uncommon.
- However, undetected diabetes mellitus is a potential, often overlooked, cause of such complications.
Observation:
- Six patients with suspected diabetic tendencies, identified by personal/family history or unusual complications, were studied.
- This led to an investigation into the role of silent or undiagnosed diabetes in surgical outcomes.
Findings:
- A positive family history of diabetes is a significant indicator for further investigation.
- Glucose tolerance tests are vital for diagnosing suspected cases.
- Some patients with a family history of diabetes and prior infections exhibit immune system deficiencies, even with normal glucose tolerance tests.
Implications:
- Healthcare providers should discuss the heightened risk of infection and delayed healing with at-risk patients.
- Conservative surgical approaches and perioperative antibiotic prophylaxis are recommended for these individuals.
- Early identification and management of diabetes in surgical candidates can prevent adverse outcomes.