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

Abstract

Objective: To test the hypothesis that subcutaneous wound oxygen tension (PsqO₂) has a predictive relation to the development of wound infection in surgical patients. Design: A noninterventional, prospective study. Setting: A university department of surgery. Patients: One hundred thirty operative general surgical patients at notable risk of infection as predicted by an anticipated Study on the Effect of Nosocomial Infection Control (SENIC) score of 1 or greater. Outcome Measures: PsqO₂was measured perioperatively. Its relation to the subsequent incidence of surgical wound infection was then determined and compared with the SENIC score as a criterion standard. Results: Although the SENIC score and PsqO₂are inversely correlated, PsqO2 is the stronger predictor of infection. Low PsqO₂identified patients at risk and concentrated them in a cohort that was about half the size of that identified by the SENIC score. Conclusions: Subcutaneous perfusion and oxygenation are important components of immunity to wound infections. The SENIC score identifies systemic physiological variables that are important to the development of wound infection. Nevertheless, PsqO₂More-he more powerful predictor of wound infection. Moreover, PPsq_Ocan be manipulated by available clinical means, and thus may direct interventions to prevent infection. Arch Surg. 1997;132:997-1004