Perioperative hyperoxygenation and wound site infection following surgery for acute appendicitis: a randomized,
Amitai Bickel1, Michael Gurevits, Ronny Vamos
1Department of Surgery, Western Galilee Hospital, PO Box 21, Nahariya, Israel. amitai@netvision.net.il
Objective:
To assess the influence of hyperoxygenation on surgical site infection by using the most homogeneous study population.
Design:
A randomized, prospective, controlled trial.
Setting:
Department of surgery in a government hospital.
Patients:
A total of 210 patients who underwent open surgery for acute appendicitis. In the study group, patients received 80% oxygen during anesthesia, followed by high-flow oxygen for 2 hours in the recovery room. The control group received 30% oxygen, as usual.
Intervention:
Open appendectomy via incision in the right lower quadrant of the abdomen.
Main Outcome Measures:
Surgical site infection, mainly assessed by the ASEPSIS (additional treatment, serous discharge, erythema, purulent discharge, separation of deep tissues, isolation of bacteria, and stay in hospital prolonged >14 days) system score.
Results:
Surgical site infections were recorded in 6 of 107 patients (5.6%) in the study group vs 14 of 103 patients (13.6%) in the control group (P = .04). Significant differences in the ASEPSIS score were also found. The mean hospital stay was longer in the control group (2.92 days) compared with the study group (2.51 days) (P = .01).
Conclusion:
The use of supplemental oxygen is advantageous in operations for acute appendicitis by reducing surgical site infection rate and hospital stay.
Trial Registration:
clinicaltrials.gov Identifier: NCT01002365.
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