|
|
October 16-20, 2010 San Diego, CA Home Abstract Archive Search Abstracts 2010 Session Grid 2010 Meeting Website Policy Statements ASA Website Feedback 
Visit Anesthesiology.org |
| Previous Abstract | Next Abstract |
| Printable Version |
|
A1681
October 22, 2008 9:00 AM - 11:00 AM Room Hall E2-Area G, |
||||||||||||||||||||||||||||||||||||
| Oxygen Saturation at Thenar Eminence Predicts Surgical Wound Infections | ||||||||||||||||||||||||||||||||||||
|
Raghavendra Govinda, M.D., Yusuke Kasuya, M.D., Ramatia Mahboobi, M.D., Jagan Devarajan, M.D., F.R.C.A., Ozan Akça, M.D. Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, Kentucky |
||||||||||||||||||||||||||||||||||||
|
Background: Subcutaneous oxygen tension is a major factor influencing the incidence of surgical wound infections (SWI) (1,2). Risk of SWI inversely correlates with subcutaneous tissue oxygen tension (StO2) (2). However, measuring StO2 requires an invasive subcutaneous probe (2). A small randomized study showed that StO2, measured with non-invasive near infrared spectroscopy, was a better predictor of SWI than the National Nosocomial Infection Surveillance (NNIS) risk index (3). Using this technology, we determined the relationship of early postoperative regional and remote StO2 and the development of SWI. Methods: With IRB approval and informed consent, we recruited 82 adult patients undergoing colon resection. Tissue oxygen tension (StO2) was measured 75 minutes after surgery in the PACU after patients were weaned off oxygen. StO2 was measured with the InspectraTM tissue spectrometer model 325 (Hutchinson Technology Inc, Hutchinson, MN) at upper 1/3rd, middle 1/3rd and lower 1/3rd of the incision 1” away from the incision, on the lateral aspect of the upper arm, and on the thenar eminence. Mean blood pressure, oxygen saturation, and pain scores were also recorded. An independent investigator blinded to study purpose assessed patients for SWI daily during in the hospital and on the 30th postoperative day. Receiver–operator characteristic (ROC) curves were used to analyze the performance of StO2 as a predictor of SWI. Results: Mean blood pressure, pulse oximeter readings, and pain scores did not differ between the two groups. Of the 82 patients involved in the study 15 (18%) developed SWI. Patients that did not develop infections and those that did were similar in age (48±15 vs 43±16, p = 0.23), sex ratio (M:F 37:45), and BMI (27±7 vs 30±8, p = 0.13). StO2 was similar in the two groups at all sites measured except at the thenar eminence.[table1]From the logistic regression, the area under the ROC curve was 0.75 (Fig 1). Using a StO2 of 67% as the predictive cut-point, the sensitivity was 89% and the specificity was 58%.[figure1]Conclusion: Tissue oxygen saturation measured at the thenar eminence in the immediate recovery period (75 min after surgery) was statistically less in patients who eventually developed SWI. It appears that postoperative thenar eminence StO2 might be used as a tool to predict SWI after colon resection surgery. References: 1. Greif R, et al. N Engl J Med 2000; 342: 16.1-7 2. Hopf HW, et al. Arch Surg 1997; 132: 997-1004; discussion 1005. 3. Ives CL, et al. Br J Surg 2007; 94: 87.-91. Anesthesiology 2008; 109 A1681 |
||||||||||||||||||||||||||||||||||||
|
Figure 1
 |