Supplemental Perioperative Oxygen and the Risk of Surgical Wound Infection: A Randomized Controlled Trial

Belda, F. Javier; Aguilera, Luciano; Asunción, José García de la; Alberti, Javier; Vicente, R.; Ferrandiz, Lucia; Rodriquez, Rafael; Sessler, Daniel I.; Aguilar, Gerardo; Botello, Stephanie García; Ortí, Rafael

doi:10.1097/01.ogx.0000201918.45088.1a

Cited by 56 publications

(115 citation statements)

References 17 publications

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“…Risk difference was 0.0531, attributable risk (AR) was 38.42 % and relative risk (RR) was 1.62. All these results suggest that there is similar reduction in the rates of SSI with 60 % oxygen supplementation in comparison with studies of Belda FJ et al showing 39 % lowered risk [6]. Al Niami and team had a relative risk of 0.70.…”

Section: Discussionsupporting

confidence: 73%

“…Belda FJ and others in their study showed that SSI occurred in 24.4 % of patients who were administered 30 % FiO 2 and 14.9 % of patients in the 80 %-FiO 2 -administered group. The risk of SSI was found to be 39 % lower in the 80 %-FIO 2 group [6].…”

Section: Discussionmentioning

confidence: 81%

“…The effect of perioperative oxygen supplementation continues to be under debate with proponents and opponents firmly divided over the issue. It has been argued by some researchers that there is benefit in reducing surgical site infection [5,6,15].…”

Section: Discussionmentioning

confidence: 99%

“…This is vital for healing [3] and critical for prevention of infections by releasing reactive oxygen species [4]. Although higher concentrations of oxygen supplementation (80 %) were found to reduce SSI by half, inspiring a higher concentration of oxygen is not devoid of complications [5,6]. It can induce lung injury and atelectasis in patients at risk [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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Rational Hyperoxia in the Perioperative Period: a Safe and Effective Tool in the Reduction of SSI

et al. 2015

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Oxygen supplemented at a concentration higher than 40-50 % for at least 2 h perioperatively is expected to reduce surgical site infections (SSI). Although supplementation of 80 % of oxygen perioperatively has shown to reduce SSI in various studies, this concentration is known to be associated with airway complications. This study was taken up to assess the efficacy of 60 %, i.e. <80 and >50 %, inspired oxygen supplemented perioperatively in reducing SSI. One hundred and eighty-eight patients who underwent elective class I and II surgeries were studied. Patients were divided equally into two groups and subgroups and matched for age, sex, type of surgeries, etc. The control group received 30 % and the study group received 60 % oxygen supplementation perioperatively for 2 h. Wounds were observed for the development of SSI. 8/94 patients in the study group and 13/94 patients in the control group developed SSI (p<0.01). The results indicate a relative risk of 1.62, risk difference of 0.0531 and attributable risk of 38.42 %. Hence, it may be concluded that perioperative oxygen supplementation at 60 % concentration reduces SSI.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Rational Hyperoxia in the Perioperative Period: a Safe and Effective Tool in the Reduction of SSI

et al. 2015

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“…The authors suggest a number of cell-level mechanisms to explain this finding; nevertheless, the results have not since been replicated. Five other randomized trials have been reported in the literature, [36][37][38][39][40] and all but one 36 have shown equivalence.…”

Section: Hyperoxiamentioning

confidence: 99%

Review article: The anesthesiologist’s role in the prevention of surgical site infections

Forbes

McLean

2012

Can J Anesth/J Can Anesth

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Purpose To highlight the role of anesthesiologists in the prophylaxis of surgical site infections (SSIs) and to recognize the central role they play in quality improvement initiatives for the prevention of SSIs. Source The medical literature was searched with a focus on three interventions affecting the risk of SSIs: preoperative antibiotic administration, perioperative normothermia, and perioperative hyperoxia. The literature was also searched for examples of initiatives in patient safety and quality improvement that highlight the role of anesthesiologists in preventing SSIs. Principal findings The timely administration of preoperative antibiotics and the maintenance of perioperative normothermia have been shown to reduce the risk of SSI significantly. Perioperative hyperoxia in the prevention of SSIs remains controversial but may improve outcomes in specific subsets of the surgical population. Initiatives in quality improvement show the challenges faced by many centres to improve upon these processes of care, but they also highlight the role of anesthesiologists as champions in the multidisciplinary efforts for the prevention of SSIs. Conclusions Anesthesiologists are responsible for many of the processes of care shown to impact the risk for SSIs, and they play an important role in the prevention of SSIs.

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Systemic Review and Meta-analysis of Randomized Clinical Trials Comparing Primary vs Delayed Primary Skin Closure in Contaminated and Dirty Abdominal Incisions

Bhangu¹,

Singh²,

Lundy

et al. 2013

JAMA Surg

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Supplemental Perioperative Oxygen and the Risk of Surgical Wound Infection: A Randomized Controlled Trial

Cited by 56 publications

References 17 publications

Rational Hyperoxia in the Perioperative Period: a Safe and Effective Tool in the Reduction of SSI

Rational Hyperoxia in the Perioperative Period: a Safe and Effective Tool in the Reduction of SSI

Review article: The anesthesiologist’s role in the prevention of surgical site infections

Systemic Review and Meta-analysis of Randomized Clinical Trials Comparing Primary vs Delayed Primary Skin Closure in Contaminated and Dirty Abdominal Incisions

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