Hyperoxia and infection

Surgical wound infection remains a common and serious complication of surgery. Patient factors are a major determinant of wound outcome following surgery. Co-morbidities clearly contribute, but environmental stressors as well the individual response to stress may be equally important. In particular, wounds are exquisitely sensitive to hypoxia, which is both common and preventable. Perioperative management can promote postoperative wound healing and resistance to infection. Maintaining perfusion and oxygenation of the wound is paramount. Once perfusion is assured, addition of increased inspired oxygen substantially reduces surgical site infection in at risk patients. A greater degree of hyperoxemia, achievable with administration of hyperbaric oxygen, is useful as an adjunct to the treatment of serious soft tissue and bone infections in selected patients. This article will review the basic science underlying these observations, along with the clinical data that support the use of hyperoxia in preventing and treating infections.