WOUND TISSUE OXYGEN-TENSION PREDICTS THE RISK OF WOUND-INFECTION IN SURGICAL PATIENTS

Objective: To test the hypothesis that subcutaneous wound oxygen tensi on (PsqO(2)) has a predictive relation to the development of wound inf ection in surgical patients. Design: A noninterventional, prospective study. Setting: A university department of surgery. Patients: One hund red thirty operative general surgical patients at notable risk of infe ction as predicted by an anticipated Study on the Effect of Nosocomial Infection Control (SENIC) score of 1 or greater. Outcome Measures: Ps qO(2) was measured perioperatively. Its relation to the subsequent inc idence of surgical wound infection was then determined and compared wi th the SENIC score as a criterion standard. Results: Although the SENI C score and PsqO(2) are inversely correlated, PsqO(2) is the stronger predictor of infection. Low PsqO(2) identified patients at risk and co ncentrated them in a cohort that was about half the size of that ident ified by the SENIC score. Conclusions: Subcutaneous perfusion and oxyg enation are important components of immunity to wound infections. The SENIC score identifies systemic physiological variables that are impor tant to the development of wound infection. Nevertheless, PsqO(2) is t he more powerful predictor of wound infection. Moreover, PsqO(2) can b e manipulated by available clinical means, and thus may direct interve ntions to prevent infection.