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April 28, 2004

Supplemental Oxygen and Risk of Surgical Site Infection

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(16):1956. doi:10.1001/jama.291.16.1956-b

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.

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