Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: The results of the study by
Dr Pryor et al1 contradict our finding that
supplemental oxygen halves the risk of surgical wound infection.2 The
risk of infection was greater in the patients given 80% oxygen (11% vs 25%).
An infection rate of 25% far exceeds those reported in any large study of
comparable operations.3 The conclusion that
supplemental oxygen increases infection rates conflicts with in vitro and
in vivo evidence that oxidative killing by neutrophils, the primary defense
against surgical pathogens, depends critically on tissue oxygenation.4 In contrast, there is little mechanistic basis
to suggest that supplemental oxygen would reduce resistance to infection.
The results of Pryor et al not only contradict our report,2 but
also contradict those of a study by Hopf et al5 in
which there was a significant inverse relationship between tissue oxygen tension
and infection risk.
Akça O, Sessler DI. Supplemental Oxygen and Risk of Surgical Site Infection. JAMA. 2004;291(16):1956. doi:10.1001/jama.291.16.1956-b