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World J Surg ; 35(6): 1387-95, 2011 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-21476113

RESUMEN

BACKGROUND: Surgical wound infection (SWI) is a common complication after peripheral vascular surgery. Infections increase morbidity and costs of treatment. The aim of the present study was to test the hypothesis that supplemental postoperative oxygen decreases the incidence of SWI after lower limb revascularization. METHODS: This prospective, randomized, multicenter, single-blinded trial was conducted between May 2009 and February 2010 in six secondary referral hospitals in Finland. We randomly allocated 274 patients undergoing surgery for lower limb revascularization to the study group (n=137) or a control group (n=137). The study group received supplemental inspired oxygen for the first 2 days after surgery. The main outcome was SWI. Patients were followed up for 30 days or until the SWI was healed. Logistic regression analysis was used to assess the independent effect of supplemental oxygen on the incidence of SWI. RESULTS: Altogether 63 (23%) patients developed SWI; 47 (75%) of the infections were superficial. There were two vascular graft infections. SWI occurred in 25 patients (18.2%) in the study group and in 38 patients (27.7%) in the control group [odds ratio (OR) 0.56, 95% confidence interval (CI) 0.30-1.04; P=0.07]. In isolated groin incisions, 3 patients of 52 (5.8%) in the study group and 12 patients of 51 (23.5%) in the control group developed SWI; OR=0.20, 95% CI 0.04-0.95; P=0.04. CONCLUSIONS: There was an indication that supplemental inspired oxygen tended to decrease the incidence of SWI after lower limb vascular surgery. In isolated groin incisions, the decrease of SWI incidence in the supplemental oxygen group was significant.


Asunto(s)
Terapia por Inhalación de Oxígeno/métodos , Enfermedades Vasculares Periféricas/cirugía , Infección de la Herida Quirúrgica/terapia , Procedimientos Quirúrgicos Vasculares/efectos adversos , Cicatrización de Heridas/fisiología , Anciano , Anciano de 80 o más Años , Intervalos de Confianza , Femenino , Finlandia , Estudios de Seguimiento , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Enfermedades Vasculares Periféricas/diagnóstico , Cuidados Posoperatorios/métodos , Estudios Prospectivos , Valores de Referencia , Medición de Riesgo , Método Simple Ciego , Estadísticas no Paramétricas , Infección de la Herida Quirúrgica/prevención & control , Resultado del Tratamiento , Procedimientos Quirúrgicos Vasculares/métodos
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