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.
Dellinger EP. Increasing Inspired Oxygen to Decrease Surgical Site InfectionTime to Shift the Quality Improvement Research Paradigm. JAMA. 2005;294(16):2091–2092. doi:10.1001/jama.294.16.2091
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