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Rational Hyperoxia in the Perioperative Period: a Safe and Effective Tool in the Reduction of SSI
Tejaswini Vallabha1, Uday Karjol1, Vijayakumar Kalyanappagol1
1Department of Surgery, Shri BM Patil Medical College & Research Centre, BLDE University, Sholapur Road, Vijayapura (Bijapur), Karnataka 586103 India.
Abstract:
Oxygen supplemented at a concentration higher than 40-50 % for at least 2 h perioperatively is expected to reduce surgical site infections (SSI). Although supplementation of 80 % of oxygen perioperatively has shown to reduce SSI in various studies, this concentration is known to be associated with airway complications. This study was taken up to assess the efficacy of 60 %, i.e. <80 and >50 %, inspired oxygen supplemented perioperatively in reducing SSI. One hundred and eighty-eight patients who underwent elective class I and II surgeries were studied. Patients were divided equally into two groups and subgroups and matched for age, sex, type of surgeries, etc. The control group received 30 % and the study group received 60 % oxygen supplementation perioperatively for 2 h. Wounds were observed for the development of SSI. 8/94 patients in the study group and 13/94 patients in the control group developed SSI (p < 0.01). The results indicate a relative risk of 1.62, risk difference of 0.0531 and attributable risk of 38.42 %. Hence, it may be concluded that perioperative oxygen supplementation at 60 % concentration reduces SSI.
Insights
Perioperative oxygen supplementation at 60% concentration can significantly reduce surgical site infections (SSI). This study found a lower incidence of SSI in patients receiving 60% oxygen compared to those receiving 30% oxygen.
Area of Science:
- Medical Research
- Surgical Innovation
- Infection Control
Background:
- Perioperative oxygen supplementation above 40-50% for at least 2 hours is theorized to decrease surgical site infections (SSI).
- While 80% oxygen has shown SSI reduction, it carries risks of airway complications.
- A need exists to evaluate intermediate oxygen concentrations for SSI prevention.
Purpose of the Study:
- To assess the efficacy of 60% inspired oxygen in reducing perioperative surgical site infections (SSI).
- To compare SSI rates between patients receiving 60% and 30% oxygen perioperatively.
Main Methods:
- A study involving 188 patients undergoing elective class I and II surgeries.
- Patients were equally divided into a control group (30% oxygen) and a study group (60% oxygen) for 2 hours perioperatively.
- Groups were matched for age, sex, and surgical type, with wound observation for SSI development.
Main Results:
- 8 out of 94 patients in the 60% oxygen group developed SSI.
- 13 out of 94 patients in the 30% oxygen group developed SSI (p < 0.01).
- The 60% oxygen group demonstrated a relative risk of 1.62 for SSI, with a risk difference of 0.0531.
Conclusions:
- Perioperative oxygen supplementation at 60% concentration is effective in reducing surgical site infections (SSI).
- This concentration appears to offer a balance, potentially mitigating risks associated with higher oxygen levels.
- Further research may explore optimal oxygen concentrations for SSI prevention in diverse surgical settings.
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