Oxygen, wound healing and the development of infection. Present status

Wounds do not heal in tissue that does not bleed and almost always heal in tissue that bleeds extensively. A continuous supply of oxygen to the tissue is vital for the healing process and to resist infection. External factors may decrease the peripheral oxygen supply, but supplementary perioperative oxygen reduces the surgical wound infection rate to half in patients having colorectal resections. Hyperbaric oxygen may be beneficial when the flow and oxygen supply to the healing tissue are compromised by local injury and particularly if anaerobic infection is present. Assessment of perfusion and oxygenation is essential during and after surgery.