title: High-concentration supplemental perioperative oxygen and surgical site infection following elective colorectal surgery for rectal cancer: a prospective, randomized, double-blind, controlled, single-site trial.
abstract: BACKGROUND
  Perioperative supplemental oxygen has been proposed to decrease the incidence of surgical site infection (SSI) in colorectal surgery with controversial results. We have assessed the influence of hyperoxygenation on SSI by using the most homogeneous study population.
  
  
  METHODS
  We studied, in a prospective randomized study, 81 patients, who underwent elective open infraperitoneal anastomosis for rectal cancer. Patients were assigned randomly to an oxygen/air mixture with a fraction of inspired oxygen (FiO2) of 30% (n = 41) or 80% (n = 40). Administration was commenced after induction of anesthesia and maintained for 6 hours after surgery.
  
  
  RESULTS
  The overall wound infection rate was 21%: 11 patients (26.8%) had wound infections in the 30% FiO2 group and 6 (15%) in the 80% FiO2 group (P < .05). The risk of SSI was 41% lower in the 80% FiO2 group.
  
  
  CONCLUSIONS
  Supplemental 80% FiO2 reduced postoperative SSI with few risks to the patient and little associated cost.
authors: Department of Surgery, University of L'Aquila, L'Aquila, Italy.
authors: Mario
authors: M
authors: Schietroma
authors: Department of Surgery, University of L'Aquila, L'Aquila, Italy.
authors: Emanuela M
authors: EM
authors: Cecilia
authors: Department of Surgery, University of L'Aquila, L'Aquila, Italy.
authors: Federico
authors: F
authors: Sista
authors: Department of Surgery, University of L'Aquila, L'Aquila, Italy.
authors: Francesco
authors: F
authors: Carlei
authors: Department of Surgery, University of L'Aquila, L'Aquila, Italy. Electronic address: pessiabeatrice87@gmail.com.
authors: Beatrice
authors: B
authors: Pessia
authors: Department of Surgery, University of L'Aquila, L'Aquila, Italy.
authors: Gianfranco
authors: G
authors: Amicucci
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D004311:Double-Blind Method; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D019990:Perioperative Care / Q000379:methods*; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D016896:Treatment Outcome
keywords: Colorectal surgery; Rectal cancer; Surgical site infection