Comparison between High versus Low Fraction of inspired Oxygen on Incidence of Postoperative Surgical Site Infection in Abdominal Hysterectomy

Abstract

nfection is a major complication of surgical procedures, and among surgical patients, surgical site infection (SSI) is the most common nosocomial infection. SSIs prolong hospitalization, increase the cost of care, and are associated with excess mortality. Prevention of SSI is essential. Oxidative killing by neutrophils has been shown to represent a major defense against SSI. Oxidative killing is enhanced by high oxygen tension in the tissues, which reduces the risk of SSI. Perioperative supplemental oxygenation to increase oxygen partial pressures in tissues has been studied as a means to reduce SSI. Hence, most of the guidelines published recently for the prevention of SSI have included the use of high FiO2 perioperatively as a means for reducing the incidence of infection. Yet, it remains a source of debate since most guidelines are based on evidences of moderate quality. Several randomized controlled trials have been conducted over the years but none was conclusive regarding the benefit of hyperoxygenation on decreasing the incidence of SSIs.