Author Affiliation: Department of Outcomes Research, The Cleveland Clinic, Ohio.
Bickel et al1 report that “supplemental oxygen is advantageous in operations for acute appendicitis by reducing surgical site infection rate and hospital stay.” There are several curious aspects of their report. For example, although they state that their aim was to “obtain solid information considering the effects of hyperoxygenation on surgical site infection,” no hypothesis is specified. It appears that their primary outcomes were the presence of a surgical site infection and the ASEPSIS (additional treatment, serous discharge, erythema, purulent discharge, separation of deep tissues, isolation of bacteria, and stay in hospital prolonged >14 days) system score, but the a priori primary outcomes are not specified in the article or in the associated clinicaltrials.gov registry.
Sessler DI. Supplemental Oxygen and Surgical Site Infection. Arch Surg. 2011;146(10):1221–1223. doi:10.1001/archsurg.2011.290