Role of hyperoxygenation on surgical site wound infection: a randomised case control study

Authors

  • Samba Siva Rao G. Department of General Surgery, 2Mamata Medical College, Khammam, Telangana, India
  • Kiran Kumar Suggala Department of Anaesthesia, Mamata Medical College, Khammam, Telangana, India

DOI:

https://doi.org/10.18203/2349-2902.isj20193344

Keywords:

Elective surgery, Hospital stay, Hyperoxygenation, Surgical site infection

Abstract

Background: The aim of this study was to assess the influence of hyperoxygenation on surgical site wound infections.

Methods: Using prospective randomized study, conducted from January 2018 to December 2018 at Mamata Medical College and General hospital, Khammam. This study includes 100 patients who were going for elective surgery at various divisions of Department of surgery. Patients were assigned randomly to an oxygen/air mixture with a faction of inspiration (FiO2) of 30% (n=50) and 60% (n=50). Administration was started after induction of anaesthesia and maintained for 3hours after surgery.

Results: Surgical site infection was recorded in 5 patients (2 of 50, 10%) in the hyperoxygenation group and 11 patients (11 of 50, 22%) in the control group (p<0.05). Time of hospitalization was 5±3 days in the hyperoxygenation group and 9±4 days in the control group (p<0.05).

Conclusions: Hyperoxygenation was associated with a reduction in surgical site infection. It also decreases the duration of hospital stay and decreases economic burden.

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References

Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guidelines for prevention of surgical site infection. Infect Control Hosp Epidemiol. 1999;20(4):247-78.

Bratzler DW, Hunt DR. The surgical infection prevention and surgical care improvement projects: national initiatives to improve outcomes for patients having surgery. Clin Infect Dis. 2006;43(3):322-30.

Lewis RT. Oral versus systemic antibiotic prophylaxis in elective colonsurgery: a randomized study and meta-analysis send a message from the 1990s. Can J Surg. 2002;45(3):173-80.

Titlestad I, Ebbesen LS, Ainsworth AP, Lillevang ST, Qvist N, Georgsen J. Leukocyte depletion of blood components does not significantly reduce the risk of infectious complications. Results of a double-blinded, randomized study. Int J Colorectal Dis. 2001;16(3):147-53.

Pineda CE, Shelton AA, Hernandez-Boussard T, Morton JM, Welton ML. Mechanical bowel preparation in intestinal surgery: a metaanalysis and review of the literature. J Gastrointest Surg. 2008;12(11):2037-44.

Weber WP, Zwahlen M, Reck S, Feder-Mengus C, Misteli H, Rosenthal R, et al. Economic burden of surgical site infections at a European university hospital. Infect Control Hosp Epidemiol. 2008;29(7):623-9.

Hopf HW, Hunt TK, West JM, Blomquist P, Goodson WH III, Jenson A et al. Wound tissue oxygen predicts the risk of wound infection in surgical patients. Arch Surg. 1997;132(9):997-1004.

Gottrup F. Measurement and evaluation of tissue perfusion in surgery. In: Leaper DJ, Branicki FJ (eds) International surgical practice Oxford. UK: Oxford University Press; 1992:15-39.

Alvandipour M, Mokhtari-Esbuie F, Baradari AG, Firouzian A, Rezaie M. Effect of Hyperoxygenation During Surgery on Surgical Site Infection in Colorectal Surgery. Ann Coloproctol. 2019;35(1):9-14.

Scott RD. The direct medical costs of healthcare-associated infections in US hospitals and the benefits of prevention. Atlanta (GA): Division of Healthcare Quality Promotion National Center for Preparedness, Detection, and Control of Infectious Diseases, Centers for Disease Control Prevention. 2009:401-7.

Pryor KO, Fahey TJ 3rd, Lien CA, Goldstein PA. Surgical site infection and the routine use of perioperative hyperoxia in a general surgical population: a randomized controlled trial. JAMA. 2004;291(1):79-87.

Jonsson K, Jensen JA, Goodson WH 3rd, Scheuenstuhl H, West J, Hopf HW, et al. Tissue oxygenation, anemia, and perfusion in relation to wound healing in surgical patients. Ann Surg. 1991;214(5):605-13.

Jonsson K, Hunt TK, Mathes SJ. Oxygen as an isolated variable influences resistance to infection. Ann Surg. 1988;208(6):783-7.

Horikoshi T, Balin AK, Carter DM. Effect of oxygen on the growth of human epidermal keratinocytes. J Invest Dermatol. 1986;86(4):424-7.

Dimitrijevich SD, Paranjape S, Wilson JR. Effect of hyperbaric oxygen on human skin cells in culture and in human dermal and skin equivalents. Wound Repair Regen. 1999;7(1):53-64.

André Lévigne D, Modarressi A, Pignel R, Bochaton Piallat ML, Pittet Cuénod B. Hyperbaric oxygen therapy promotes wound repair in ischemic and hyperglycemic conditions, increasing tissue perfusion and collagen deposition. Wound Repair Regen. 2016;24(6):954-65.

Hopf HW, Hunt TK, West JM, Blomquist P, Goodson WH, Jensen JA et al. Wound tissue oxygen tension predicts the risk of wound infection in surgical patients. Arch Surg. 1997;132(9):997-1004.

Belda FJ, Aguilera L, García de la Asunción J, Alberti J, Vicente R, Ferrándiz L, et al. Supplemental perioperative oxygen and the risk of surgical wound infection: a randomized controlled trial. JAMA. 2005;294(16):2035-42.

Greif R, Akca O, Horn EP, Kurz A, Daniel IS. Supplemental perioperative oxygen to reduce the incidence of surgical wound infection. N Engl J Med. 2000;342(3):161-77.

Al-Niaimi A. Supplemental perioperative oxygen for reducing surgical site infection: a meta-analysis. J Eval Clin Pract. 2009;15(2):360-5.

Schietroma M, Carlei F, Cecilia EM, Piccione F, Bianchi Z, Amicucci G. Colorectal Infraperitoneal anastomosis: the effects of perioperative supplemental oxygen administration on the anastomotic dehiscence. J Gastrointest Surg. 2012;16(2):427-34.

Turan A, Apfel CC, Kumpch M, Danzeisen O, Eberhart LH, Forst H, et al. Does the efficacy of supplemental oxygen for the prevention of postoperative nausea and vomiting depend on the measured outcome, observational period or site of surgery? Anaesthesia. 2006;61:628(7)-33.

Pryor KO, Fahey TJ 3rd, Lien CA, Goldstein PA. Surgical site infection and the routine use of perioperative hyperoxia in a general surgical population: a randomized controlled trial. JAMA. 2004;291(1):79-87.

Wanta BT, Hanson KT, Hyder JA, Stewart TM, Curry TB, Berbari EF, et al. Intra-operative inspired fraction of oxygen and the risk of surgical site infections in patients with type 1 surgical incisions. Surgical infections. 2018;19(4):403-9.

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Published

2019-07-25

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Original Research Articles