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

BackgroundPerioperative 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.MethodsWe 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.ResultsThe 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.ConclusionSupplemental 80% FiO2 reduced postoperative SSI with few risks to the patient and little associated cost.