Introduction/Aim: Does the oxygen saturation of skin (SSO2) and/or muscle (MSO2) (measured by visible lightguide and near-infrared spectrophotometry respectively) predict wound infections after major surgery?
Methods: In patients undergoing elective surgery SSO2 and MSO2 were measured on the arm and abdomen pre-operatively then at 6, 12, 24 and 48 hours post-operatively. Age, weight, height and triceps skinfold thickness were recorded. An independent assessor monitored for signs of infection at one week and one month using the Control of Diseases Centre guidelines for diagnosis of wound infection.
Results: In the preliminary phase of our trial we have recruited 17 patients; 10 male, 7 female. Age 59.5 ± 20.9 years (mean ± s.d.). Two groups were classified retrospectively; patients with uneventful wound healing (A), and those who had wound infections within 30 days post-surgery (B). A comprised 10; 4 male, 6 female. B comprised 7; 6male, 1 female. There were no significant differences in age, BMI or triceps skinfold thickness between groups. There were no significant differences in arterial oxygen saturation, arm SSO2 and MSO2, and abdomen SSO2 between A and B at any stage. At 12 hours mean abdomen MSO2 in A was 27.8% higher than B (p=0.02). Mean abdomen MSO2 value in A was higher than B at 6 hours but not significant (p=0.075). A paired T-test showed that in A abdomen MSO2 was significantly higher at 6 and 12 hours compared to the pre-operative values; this was not observed in B.
Discussion: These preliminary results indicate that a post-operative increase in tissue oxygen saturation may be necessary to protect against surgical site infection.
Ives CL, Harrison DK, Stansby G. Prediction of surgical site infections using spectrophotometry: Preliminary results. Adv Exp Med Biol: 578: 149-154.
Dr. David K. Harrison, Durham Unit, Durham. Tel: +44 (0)191-333-2215.
Regional Medical Physics Department, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK.
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