The relationship between elevated HbA1c% and surgical site infection in patients undergoing CABG

Objective: Controversy still exists whether adequacy ofpreoperative diabetes control measured by HbA1c% is a predictor of elevated incidence of surgical site infection (SSI) after CABG.
Methods:prospective study was done on 48 diabetic patients underwent CABG surgery. They were classified into 2 groups, Group (A):24 patients with fair glycemic control (HbA1c isunder or equal to 7%), Group (B): 24 patients with poor glycemic control (HbA1c above 7%). SSI either sternotomy or saphenous wound infection were studied in both groups.
Results: Superficial wound infection for group A was 12.5% and 25% for group B with significant statistical differenceamong the two groups. Deep Sternal Wound Infection (DSWI) was (4.1%) group A and group B with no statistical significance.As regard Saphenous wound infection was (8.3%) for groupA and (25%) for group B with statistical difference, also group B has higher frequency of hospital re-admission and need inotropes more than groupA. 
Conclusions: Elevated HbA1c >7 in patients undergoing CABG associated with increasedfrequency of SWI and saphenous harvesting site infection but there was no significant increase in DSWI.Patients with elevated HbA1c >7 has more resistant peri-operative control of RBS. Finally we found that good peri-operative control of RBS associated with decreased rate of SSI after CABG. HbA1c  is simple test that may offer the surgeon with better risk profile assessment and give additional prognostic data when discussing morbidity and mortality risks with patients and their relatives.