Perioperative hyperoxygenation and wound site infection following surgery for acute appendicitis: A randomized, prospective, controlled trial

Objective: To assess the influence of hyperoxygenation on surgical site infection by using the most homogeneous study population. Design: A randomized, prospective, controlled trial. Setting: Department of surgery in a government hospital. Patients: A total of 210 patients who underwent open surgery for acute appendicitis. In the study group, patients received 80% oxygen during anesthesia, followed by high-flow oxygen for 2 hours in the recovery room. The control group received 30% oxygen, as usual. Intervention: Open appendectomy via incision in the right lower quadrant of the abdomen. Main Outcome Measures: Surgical site infection, mainly 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. Results: Surgical site infections were recorded in 6 of 107 patients (5.6%) in the study group vs 14 of 103 patients (13.6%) in the control group (P=.04). Significant differences in the ASEPSIS score were also found. The mean hospital stay was longer in the control group (2.92 days) compared with the study group (2.51 days) (P=.01). Conclusion: The use of supplemental oxygen is advantageous in operations for acute appendicitis by reducing surgical site infection rate and hospital stay.