• Amitai Bickel, Michael Gurevits, Ronny Vamos, Simon Ivry, and Arieh Eitan.
• Department of Surgery, Western Galilee Hospital, PO Box 21, Nahariya, Israel. amitai@netvision.net.il
• Arch Surg. 2011 Apr 1;146(4):464-70.

ObjectiveTo assess the influence of hyperoxygenation on surgical site infection by using the most homogeneous study population.DesignA randomized, prospective, controlled trial.SettingDepartment of surgery in a government hospital.PatientsA 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.InterventionOpen appendectomy via incision in the right lower quadrant of the abdomen.Main Outcome MeasuresSurgical 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.ResultsSurgical 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).ConclusionThe use of supplemental oxygen is advantageous in operations for acute appendicitis by reducing surgical site infection rate and hospital stay.Trial Registrationclinicaltrials.gov Identifier: NCT01002365.

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