24314
document
Supplemental perioperative oxygen and the risk of surgical wound infection : a randomized controlled trial . CONTEXT Supplemental perioperative oxygen has been variously reported to halve or double the risk of surgical wound infection . OBJECTIVE To test the hypothesis that supplemental oxygen reduces infection risk in patients following colorectal surgery . DESIGN , SETTING , AND PATIENTS A double-blind , randomized controlled trial of 300 patients aged 18 to 80 years who underwent elective colorectal surgery in 14 Spanish hospitals from March 1 , 2003 , to October 31 , 2004 . Wound infections were diagnosed by blinded investigators using Centers for Disease Control and Prevention criteria . Baseline patient characteristics , anesthetic treatment , and potential confounding factors were recorded . INTERVENTIONS Patients were randomly assigned to either 30 % or 80 % fraction of inspired oxygen ( FIO2 ) intraoperatively and for 6 hours after surgery . Anesthetic treatment and antibiotic administration were standardized . MAIN OUTCOME MEASURES Any surgical site infection ( SSI ) ; secondary outcomes included return of bowel function and ability to tolerate solid food , ambulation , suture removal , and duration of hospitalization . RESULTS A total of 143 patients received 30 % perioperative oxygen and 148 received 80 % perioperative oxygen . Surgical site infection occurred in 35 patients ( 24.4 % ) administered 30 % FIO2 and in 22 patients ( 14.9 % ) administered 80 % FIO2 ( P=.04 ) . The risk of SSI was 39 % lower in the 80 % FIO2 group ( relative risk [ RR ] , 0.61 ; 95 % confidence interval [ CI ] , 0.38-0.98 ) vs the 30 % FIO2 group . After adjustment for important covariates , the RR of infection in patients administered supplemental oxygen was 0.46 ( 95 % CI , 0.22-0.95 ; P = .04 ) . None of the secondary outcomes varied significantly between the 2 treatment groups . CONCLUSIONS Patients receiving supplemental inspired oxygen had a significant reduction in the risk of wound infection . Supplemental oxygen appears to be an effective intervention to reduce SSI in patients undergoing colon or rectal surgery . Trial Registration ClinicalTrials.gov Identifier : NCT00235456 .
24315
Intervention_Pharmacological
Supplemental perioperative oxygen
24316
Intervention_Pharmacological
Supplemental perioperative oxygen
24317
Intervention_Pharmacological
supplemental oxygen
24318
Intervention_Pharmacological
30 % or 80 % fraction of inspired oxygen
24319
Intervention_Pharmacological
30 % perioperative oxygen
24320
Intervention_Pharmacological
80 % perioperative oxygen
24321
Intervention_Pharmacological
80 % FIO2
24322
Intervention_Pharmacological
30 % FIO2
24323
Intervention_Pharmacological
supplemental inspired oxygen
24324
Intervention_Pharmacological
Supplemental oxygen
24325
Outcome_Physical
surgical wound infection
24326
Outcome_Physical
surgical wound infection
24327
Outcome_Physical
Any surgical site infection
24328
Outcome_Physical
return of bowel function
24329
Outcome_Physical
ability to tolerate solid food
24330
Outcome_Physical
ambulation
24331
Outcome_Physical
suture removal
24332
Outcome_Other
duration of hospitalization
24333
Outcome_Physical
Surgical site infection
24334
Outcome_Physical
risk of SSI
24335
Outcome_Physical
risk of wound infection
24336
Outcome_Physical
SSI