Abstract

Abstract Diabetic patients are predisposed to adverse complications after surgery, especially when their A1c is above 8. 0% (1). Despite the heightened risk for post-operative complications such as wound dehiscence and infection (2), no formal recommendations by the American Council of Academic Plastic Surgeons (ACAPS) exist regarding preoperative A1c thresholds. This study reviews the current online recommendations for diabetic patients undergoing plastic surgery and examines the readability and technical metrics presented on these webpages. We hypothesized that these webpages would enforce stricter preoperative A1c levels (< 8%) in comparison to the 8% threshold put forth by Diabetes Care in 2014. An anonymous, depersonalized Google search with the search term "diabetes and plastic surgery" was run. The initial 50 results were analyzed and 11 webpages meeting inclusion criteria extracted. 45.45% (5/11) of the webpages stated specific A1c recommendations, with 4 of the webpages recommending an A1c <7% and one webpage recommending an A1c <6%. A number of the websites recommended that patients consult their primary care physician (PCP) or endocrinologist, 63.6% (7/11). 100% (11/11) of webpages discussed poor wound healing and 45% (5/11) discussed the heightened risk of postoperative infection in diabetic surgical patients. Webpage average readability scores for seven readability measures greatly exceeded the 6th grade reading level recommended for medical information. This study determined that online resources for diabetic patients undergoing plastic surgery utilized stricter than standard preoperative criteria and exceeded recommended readability levels. Standardizing requirements for diabetic patients and improving readability may help patients better understand the preoperative expectation for better surgical outcomes.

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