Pression sous-cutanée en oxygène (PSCO2) périopératoire : pourquoi et comment l'améliorer ?

Oxygen tissue supply depends on cardiac output, arterial oxygen content and tissue perfusion. The amount of oxygen transferred from the capillary vessels to the cells is related to the pressure gradient and the exchange surface and inversely related to the distance between the capillary vessels and the cells (Fick law). There is a relationship between subcutaneous oxygen partial pressure (PSCO2) and infectious risk. Normothermia and the use of high FiO2 per and postoperatively improve PSCO2 and decrease the incidence of surgical scare infection. Moderate hypercapnia, prevention of hypovolemia, and analgesia improve PSCO2 without evidence of prevention of parietal infection. Overweight, active smoking, and laparoscopic surgery decrease PSCO2 during surgery and may favor postoperative parietal infection. Effective and non expansive procedures may improve tissue perfusion and decrease the incidence of infection.