Systemic and nutritional considerations in diabetic wound healing.

Metabolic and nutritional aspects of wound healing are discussed in this article, as well as the effects of both acute and chronic hyperglycemia, hyperinsulinemia, end-organ complications of diabetes, and impaired nutritional status of wound healing. Specific recommendations regarding the perioperative management of patients with diabetes mellitus are set forth, and the importance of achieving tight glucose control and overall improved metabolic control are emphasized.