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Editorial
October 26, 2005

Increasing Inspired Oxygen to Decrease Surgical Site InfectionTime to Shift the Quality Improvement Research Paradigm

Author Affiliations
 

Author Affiliation: Department of Surgery, University of Washington School of Medicine, Seattle.

JAMA. 2005;294(16):2091-2092. doi:10.1001/jama.294.16.2091

Patients who develop a surgical site infection (SSI) have a 2-fold increase in the length of hospital stay and the risk of death1 and cost the US health care system approximately $1.8 billion per year.2 SSI is the most common preventable adverse outcome after a major operation and is the focus of several major national and international quality improvement initiatives. There is no absolute method to prevent SSI, but more than 30 years of research have shown that proper antibiotic selection and timing, clipping rather than shaving of hair, maintenance of normothermia and normoglycemia, and appropriate surgical technique are critical to reduce the risk.3 For years, surgeons have debated the benefits of higher levels of inspired oxygen in reducing SSI. In this issue of JAMA, Belda and colleagues4 report the results of their clinical trial using different inspired oxygen concentrations intraoperatively and for 6 hours after surgery in patients undergoing planned open (nonlaparoscopic) colorectal operations.

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