Operation of cancer: Higher doses of supplemental oxygen (ozone) during surgery reduces the risk of wound infections. For colon and rectal surgery half the infections appear to occur by the addition of oxygen. Article updated April 5, 2011
October 4, 2006: Source: JAMA. 2005, 294:2035-2042, 2091-2092
Higher doses of supplemental oxygen (ozone) during surgery reduces the risk of wound infections. This is the result of a randomized double-blind study in 300 patients. Especially with colon and rectal surgery, the effect of higher doses of approximately 50% oxygen. Wound infections are often the cause of death in the operation. With higher dose of added oxygen the chance to surgery-related mortality significantly reduced.
Oct. 25, 2005 - Supplemental oxygen can-Reducing Surgical site infections (SSI), According To the results of a double-blind, randomized trial published in the Oct. 26 issue of JAMA. The editorialists suggest That Should surgeons use encouragement or higher oxygen Tensions.
"Supplemental perioperative oxygen variously Has Been Reported to half or double the risk of Surgical wound infection," write F. Javier Belda, MD, PhD, from the Hospital Clínico Universitario in Valencia, Spain, and colleagues from the Spanish reducción de la Tasa de Infeccion Quirurgica Group. "Infection risk depends on tissue oxygen partial pressure and, therefore, interventions That May Increase tissue oxygenation reducing infection risk."
From March 1, 2003 to Oct. 31, 2004, at 14 Spanish Hospitals, 300 patients aged 18 to 80 years who under went elective colorectal surgery Were Either randomized to receive 30% or 80% fraction of inspired oxygen (FiO2) intraoperatively for six hours after surgery. Anesthetic treatment and antibiotic administration Were standardized, and wound infections diagnosed by blinded investigators Were Using the Centers for Disease Control and Prevention criteria. Primary endpoints Were Any SSI, and secondary endpoints Were return of bowel function and ability to Tolerate solid food, Ambulation, suture removal, and duration of hospitalizations Localization.
SSI occurred in 35 (24.4%) of 143 patients Administered FiO2 30% and in 22 (14.9%) of 148 patients Administered FiO2 80% (P = .04). Compared with the group receiving FiO2 30%, the group receiving FiO2 80% had a 39% lower risk of SSI (relative risk [RR], 0.61; [CI] 95% confidence interval, 0.38 - 0.98). After adjustment for important Covariates, the RR of infection in patient receiving supplemental oxygen was 0.46 (95% CI, 0.22 - 0.95, P = .04). The secondary outcomes Were not differentiate significantly in the two treatment groups.
"Patients receiving supplemental inspired oxygen had a significant reduction in the risk of wound infection," the authors write. "Supplemental oxygen Appears to be an effective intervention to reducing SSI patiënten colon or rectal surgery going under."
Study Limitations include baseline Roughly Twice That infection rate found in a previous study, possible effects of the diagnostic method Used to describe infection Reported on the results, and only considération Of Infection That occurred in the first 15 days after surgery.
"Supplemental 80% FiO2 and consistently for six hours after major colorectal surgery Reduced post-operative wound infection risk by Roughly a factor or two," the authors conclude the. "This result is consistent with in vitro data must available and one Other Appropriately designed randomized controlled trial. Supplemental oxygen Appears to confer few risks to the patient, HAS little associated cost, and Should Be Considered part of ongoing Quality Improvement Activities related to Surgical Care .
The Participating centers, Air Liquide Medicinal in Spain, Air Liquide Santé in France, the National Institutes of Health, the gen Foundation and the Joseph Drown Foundation have disclosed That They funded this study. The authors have disclosed no financial relationships.
Accompanying In an editorial, E. Patchen Dellinger, MD, from the University of Washington School of Medicine in Seattle, and colleagues, note thats the pooled data from all three Concerning this intervention studies do not show Any risk associated with Increased Oxygen Concentrations but suggest Rather Possible benefit.
"Surgeons Should not wait for this issue to be resolved before moving forward with this simple, inexpensive, and low-risk intervention while at the sametime Both ITS effectiveness monitoring in the community at large and the chance That compromise ITS use have unintended Consequences, "the editorialists write. "Surgeons Should the encouragement Broader use of higher oxygen Tensions for Their Patients under going major abdominal procedures and be more Involved in Quality Improvement Initiatives aimed at Reducing SSI."
Dr. Dellinger and colleagues have disclosed no financial relationships.
JAMA. 2005, 294:2035-2042, 2091-2092
