Supplemental Oxygen Reduces Surgical Infection
Condition: Wound Infection
MeSH terms: Infections; Communicable Diseases; Wound Infection
Study type: Interventional

Summary: 
      Supplemental perioperative oxygen has been reported to halve or double the risk of surgical
      wound infection. We tested the hypothesis that supplemental oxygen reduces infection risk
      following colorectal surgery. Colorectal surgery patients (n=300) were randomly assigned to
      30% or 80% FiO2 intraoperatively and 6 hours postoperatively. Wound infections were diagnosed
      by blinded investigators using Centers for Disease Control criteria. Baseline patient
      characteristics, anesthetic management, and potential confounding factors were recorded.
      Wound infection rates were compared with chi-square analysis. Logistic regression identified
      the contribution of potential confounding factors. Surgical wound infection occurred in 24.4%
      of patients receiving 30% oxygen, but only 14.9% of those receiving 80% oxygen (P<0.039).
      According to logistic regression, the relative risk of infection in patients given
      supplemental oxygen was 0.46 (P=0.035). Supplemental inspired oxygen reduced wound infection
      risk by roughly a factor of two. We thus recommend that supplemental oxygen be provided to
      patients undergoing colorectal surgery.
    

Detailed description: 
      Context: Supplemental perioperative oxygen has been variously reported to halve or double the
      risk of surgical wound infection.

      Objective: We tested the hypothesis that supplemental oxygen reduces infection risk following
      colorectal surgery.

      Design: Randomized, controlled trial. Setting: Fourteen Spanish hospitals. Patients: Three
      hundred patients undergoing elective colorectal surgery. Interventions: Patients were
      randomly assigned to either 30% or 80% FiO2 intraoperatively and for 6 hours after surgery.
      Anesthetic management and antibiotic administration were standardized.

      Main outcome measures: Wound infections were diagnosed by blinded investigators using Centers
      for Disease Control criteria. Baseline patient characteristics, anesthetic management, and
      potential confounding factors were recorded. The wound infection rate in the 30% and 80%
      oxygen groups was compared with chi-square analysis. A logistic regression was used to
      identify the contribution of potential confounding factors.
    

Intervention name(s): Perioperative supplemental oxygen; Standard oxygen
Intervention type(s): Procedure; Procedure
Intervention description(s): Patients were assigned to 80% fraction of inspired oxygen (FIO2) intraoperatively and for 6 hours after surgery. Anesthetic treatment and antibiotic administration were standardized.; Patients were assigned to 30% fraction of inspired oxygen (FIO2) intraoperatively and for 6 hours after surgery. Anesthetic treatment and antibiotic administration were standardized.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Prevention
Keywords: oxygen; surgical complications; colo-rectal resections