Wound Tissue Oxygen Tension Predicts the Risk of Wound Infection in Surgical Patients

doi:10.1001/archsurg.1997.01430330063010

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Vol. 132 No. 9, September 1997

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Wound Tissue Oxygen Tension Predicts the Risk of Wound Infection in Surgical Patients

Harriet Williams Hopf, MD; Thomas K. Hunt, MD; Judith M. West, DNS; Peter Blomquist, MD; William H. Goodson, III, MD; J. Arthur Jensen, MD; Kent Jonsson, MD; Philip B. Paty, MD; John M. Rabkin, MD; Robert A. Upton, PhD; Karl von Smitten, MD; Joanne D. Whitney, PhD

Arch Surg. 1997;132(9):997-1004.

Abstract

Objective
To test the hypothesis that subcutaneous wound oxygen tension(PsqO₂) has a predictive relation to the development of woundinfection in surgical patients.

Design
A noninterventional, prospective study.

Setting
A university department of surgery.

Patients
One hundred thirty operative general surgical patients at notablerisk of infection as predicted by an anticipated Study on theEffect of Nosocomial Infection Control (SENIC) score of 1 orgreater.

Outcome Measures
PsqO₂ was measured perioperatively. Its relation to the subsequentincidence of surgical wound infection was then determined andcompared with the SENIC score as a criterion standard.

Results
Although the SENIC score and PsqO₂ are inversely correlated,PsqO2 is the stronger predictor of infection. Low PsqO₂ identifiedpatients at risk and concentrated them in a cohort that wasabout half the size of that identified by the SENIC score.

Conclusions
Subcutaneous perfusion and oxygenation are important componentsof immunity to wound infections. The SENIC score identifiessystemic physiological variables that are important to the developmentof wound infection. Nevertheless, PsqO₂More-he more powerfulpredictor of wound infection. Moreover, PPsq_O can be manipulatedby available clinical means, and thus may direct interventionsto prevent infection.

Arch Surg. 1997;132:997-1004

Author Affiliations

From the Departments of Anesthesia (Dr Hopf), Surgery (Drs Hopf, Hunt, West, Goodson, and Jensen), and Biopharmaceutical Sciences (Dr Upton), University of California, San Francisco; the Department of Surgery, University of Lund, Malmö, Sweden (Drs Blomquist and Jonsson); the Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (Dr Paty); the Department of Surgery, University of Oregon, Portland (Dr Rabkin); the Fourth Department of Surgery, University of Helsinki, Helsinki, Finland (Dr von Smitten); and the Department of Physiological Nursing, University of Washington, Seattle (Dr Whitney).

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