Supplemental Oxygen and Surgical Site Infection in Colorectal Surgery: A Systematic Review and Meta-analysis.

Surgical site infection (SSI) is a common preventable iatrogenic infection following surgery with an approximated overall occurrence of 2-4%. Despite numerous studies, controversies still exist regarding the efficacy, safety, and cost effectiveness of strategies to decrease SSI. The World Health Organization issued recommendations for the prevention of SSIs including oxygenation with 80% fraction of inspired oxygen (FiO). The primary outcome of our systematic review and metaanalysis was the effect of high inspired FiO related to SSI in the colorectal surgery population. Secondary outcomes included incidence of anastomotic leaks and length of hospital stay. Eleven trials consisting of 8245 were included in the analysis. We found moderate quality of evidence that 80% FiO2 was not effective in reducing SSI (RR, 0.91; 95% CI, 0.74 to 1.13; P = .41) anastomotic leaks (RR, 0.75; 95% CI, 0.53 to 1.06; P = 0.10). Conversely, we found low quality evidence of no effect on length of stay measured in days (MD, 0.39; 95% CI -0.59 to 1.36; P = 0.44). Although additional studies are required to decrease heterogeneity of the studies, the current review showed high FiO does not decrease the incidence of SSI in the colorectal surgery population.