Abstract
Aim : To assess whether use of 80% oxygen reduces the frequency of surgical site infection in patients undergoing open appendectomy for appendicitis. Material & Methods : A randomised control study was conducted in the department of general surgery at NKP Salve Institute of Medical Sciences & Research Center & Lata Mangeshkar Hospital Nagpur. Sixty four patients undergoing open appendectomy via incision in the right lower quadrant of the abdomen were divided randomly into study group ie. patients receiving 80% oxygen during anesthesia, followed by high-flow oxygen for 2 hours in the recovery room and the control group receiving 30% oxygen, as usual. Surgical site infection will be assessed by 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. SPSS statistical software version 16.0 was used for data analysis. Results : The age distribution between the study and control group was statistically similar with p = 0.627. The sex distribution between the study and control group was statistically similar with p = 0.157. There were no medical comorbidities seen in both groups. The body temperature distribution between the study [mean SD = 37.020.12)] and control [mean SD = 37.06(0.24))] group was statistically similar with p = 0.272. Duration of abdominal pain was not significant with p=0.596. Preoperative analysis like WBC count, abdominal tenderness, Abdominal rigidity, hemoglobin, serum creatinine, blood urea, USG abdomen distribution was statistically not significant with p value >0.05. Duration of operation distribution between the groups was not significant with p=0.874. There was no surgical site infection seen in study as well as control group. All the cases in study as well as control group have satisfactory healing. There was significant (p=0.003) longer hospital stay in control group. Conclusion : Our study concludes that there is no role of supplemental oxygen in reducing surgical site infection in acute appendicitis.
Highlights
Surgical site infections (SSI) result in significant morbidity, delayed hospital discharge and increased healthcare costs
The age distribution between the study and control group was statistically similar with p = 0.627
60-15 b- by t test The sex distribution between the study and control group was statistically similar with p = 0.157
Summary
Surgical site infections (SSI) result in significant morbidity, delayed hospital discharge and increased healthcare costs. There is a known association between SSI and hypoperfusion, contaminated wounds, perioperative hyperglycaemia and hypothermia and obesity [1]. It has long been proposed that the use of perioperative hyperoxia to high risk patients may result in a reduction in the risk of SSIs. The converse argument is that hyperoxia is toxic to the lungs and results in increased atelectasis and, potentially, an increase in postoperative pulmonary complications [2][4]. The scientific rationale for preoperative hyperoxia is that oxidative killing by neutrophils, the primary defence against surgical pathogens, depends critically on tissue oxygenation.[5] Hopf and www.ssjournals.com
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