title: Supplemental postoperative oxygen in the prevention of surgical wound infection after lower limb vascular surgery: a randomized controlled trial.
abstract: BACKGROUND
  Surgical wound infection (SWI) is a common complication after peripheral vascular surgery. Infections increase morbidity and costs of treatment. The aim of the present study was to test the hypothesis that supplemental postoperative oxygen decreases the incidence of SWI after lower limb revascularization.
  
  
  METHODS
  This prospective, randomized, multicenter, single-blinded trial was conducted between May 2009 and February 2010 in six secondary referral hospitals in Finland. We randomly allocated 274 patients undergoing surgery for lower limb revascularization to the study group (n=137) or a control group (n=137). The study group received supplemental inspired oxygen for the first 2 days after surgery. The main outcome was SWI. Patients were followed up for 30 days or until the SWI was healed. Logistic regression analysis was used to assess the independent effect of supplemental oxygen on the incidence of SWI.
  
  
  RESULTS
  Altogether 63 (23%) patients developed SWI; 47 (75%) of the infections were superficial. There were two vascular graft infections. SWI occurred in 25 patients (18.2%) in the study group and in 38 patients (27.7%) in the control group [odds ratio (OR) 0.56, 95% confidence interval (CI) 0.30-1.04; P=0.07]. In isolated groin incisions, 3 patients of 52 (5.8%) in the study group and 12 patients of 51 (23.5%) in the control group developed SWI; OR=0.20, 95% CI 0.04-0.95; P=0.04.
  
  
  CONCLUSIONS
  There was an indication that supplemental inspired oxygen tended to decrease the incidence of SWI after lower limb vascular surgery. In isolated groin incisions, the decrease of SWI incidence in the supplemental oxygen group was significant.
authors.affiliation: Department of Surgery, North Karelia Central Hospital, Tikkamäentie 16, 80210, Joensuu, Finland. johanna.turtiainen@pkssk.fi
authors.forename: Johanna
authors.initials: J
authors.lastname: Turtiainen
authors.forename: Eija I T
authors.initials: EI
authors.lastname: Saimanen
authors.forename: Teemu J
authors.initials: TJ
authors.lastname: Partio
authors.forename: Kimmo T
authors.initials: KT
authors.lastname: Mäkinen
authors.forename: Matti T
authors.initials: MT
authors.lastname: Reinikainen
authors.forename: Jyrki J
authors.initials: JJ
authors.lastname: Virkkunen
authors.forename: Kari S
authors.initials: KS
authors.lastname: Vuorio
authors.forename: Tapio
authors.initials: T
authors.lastname: Hakala
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D016037:Single-Blind Method; D018709:Statistics, Nonparametric; D013530:Surgical Wound Infection / Q000517:prevention & control / Q000628:therapy*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D014945:Wound Healing / Q000502:physiology*