Supplemental Oxygen Reduces Surgical Infection - Full Text View

Purpose

Supplemental perioperative oxygen has been reported to halve or double the risk of surgical wound infection. We tested the hypothesis that supplemental oxygen reduces infection risk following colorectal surgery. Colorectal surgery patients (n=300) were randomly assigned to 30% or 80% FiO2 intraoperatively and 6 hours postoperatively. Wound infections were diagnosed by blinded investigators using Centers for Disease Control criteria. Baseline patient characteristics, anesthetic management, and potential confounding factors were recorded. Wound infection rates were compared with chi-square analysis. Logistic regression identified the contribution of potential confounding factors. Surgical wound infection occurred in 24.4% of patients receiving 30% oxygen, but only 14.9% of those receiving 80% oxygen (P<0.039). According to logistic regression, the relative risk of infection in patients given supplemental oxygen was 0.46 (P=0.035). Supplemental inspired oxygen reduced wound infection risk by roughly a factor of two. We thus recommend that supplemental oxygen be provided to patients undergoing colorectal surgery.

Condition	Intervention	Phase
Wound Infection	Procedure: Perioperative supplemental oxygen	Phase 2 Phase 3

Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double-Blind Primary Purpose: Prevention
Official Title:	Supplemental Perioperative Oxygen Reduces the Risk of Surgical Wound Infection: A Randomized, Double-Blind Trial

Resource links provided by NLM:

MedlinePlus related topics: Oxygen Therapy

U.S. FDA Resources

Further study details as provided by Outcomes Research Consortium:

Primary Outcome Measures:

incisional surgical wound infection

Secondary Outcome Measures:

return of bowel function and ability to tolerate solid food, ambulation, suture removal, and duration of hospitalization

Estimated Enrollment:	300
Study Start Date:	March 2003
Study Completion Date:	January 2005

Detailed Description:

Context: Supplemental perioperative oxygen has been variously reported to halve or double the risk of surgical wound infection.

Objective: We tested the hypothesis that supplemental oxygen reduces infection risk following colorectal surgery.

Design: Randomized, controlled trial. Setting: Fourteen Spanish hospitals. Patients: Three hundred patients undergoing elective colorectal surgery. Interventions: Patients were randomly assigned to either 30% or 80% FiO2 intraoperatively and for 6 hours after surgery. Anesthetic management and antibiotic administration were standardized.

Main outcome measures: Wound infections were diagnosed by blinded investigators using Centers for Disease Control criteria. Baseline patient characteristics, anesthetic management, and potential confounding factors were recorded. The wound infection rate in the 30% and 80% oxygen groups was compared with chi-square analysis. A logistic regression was used to identify the contribution of potential confounding factors.

Eligibility

Ages Eligible for Study:	18 Years to 80 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Elective colorectal resection,
Patients having abdominal-peritoneal reconstructions were included, but not those scheduled for minor colon surgery (e.g., polypectomy, isolated colostomy) or laparoscopic surgery.

Exclusion Criteria:

Exclusion criteria included expected surgery time of less than one hour, fever or existing signs of infection, diabetes mellitus (type I or II), HIV infection, weight loss exceeding 20% in the previous three months, serum albumin concentration < 30 g/L, and a leukocyte count <2500 cells/ml.

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00235456

Locations

Spain
Hospital Clínico Universitario
Valencia, Spain

Sponsors and Collaborators

Outcomes Research Consortium

Investigators

Study Director:

F. Javier Belda, MD, PhD

University of Valencia

More Information

Publications:

Belda FJ, Aguilera L, Garcia de la Asuncion J, Alberti J, Vicente R, Ferrandiz L, Rodriguez R, Company R, Sessler DI, Aguilar G, Botello SG, Orti R; Spanish Reduccion de la Tasa de Infeccion Quirurgica Group. Supplemental perioperative oxygen and the risk of surgical wound infection: a randomized controlled trial. JAMA. 2005 Oct 26;294(16):2035-42. Erratum in: JAMA. 2005 Dec 21;294(23):2973.

ClinicalTrials.gov Identifier:	NCT00235456 History of Changes
Other Study ID Numbers:	RETIQ
Study First Received:	October 6, 2005
Last Updated:	November 9, 2007
Health Authority:	Spain: Ministry of Health

Keywords provided by Outcomes Research Consortium:

oxygen
surgical complications
colo-rectal resections

Additional relevant MeSH terms:

Surgical Wound Infection
Wound Infection
Infection

Postoperative Complications
Pathologic Processes
Wounds and Injuries

ClinicalTrials.gov processed this record on May 19, 2013