Effect Of Perioperative Supplemental Oxygen For Surgical Site Infection In Patients Undergoing Colorectal Surgery: A Meta-analysis Of Randomized Controlled Trials

BackgroundSurgical site infection(SSI)means that the infection of the incision,organ,or lacunar within 30 days after the implants(1 years after the implant operation).In clinical work,the incidence rate of SSI has reached 2%-5%,but 24.3% or higher in the patients who undergo colorectal surgery.In China,a large number of colorectal operations are performed every year,most of them are colorectal tumor resections.According to the data of "2015 China Cancer Statistics",in 2015,376,300 colorectal cancer were diagnosed in China.About 93.84% of the patients was under the age of 45 and about 41.23% of the patients between 60-75.Although there is a lack of statistics,we have to admit that a lager number of patients who need surgery are also elder.Due to gastrointestinal bleeding,obstruction and other reasons,most patients suffer from varying degrees of malnutrition.Combined with the kinds and quantities of bacteria in colorectum is complex and the incision is easily contaminated during the operation,the incidence of SSI is very high.The patients who underwent colorectal surgery,in case of SSI,their hospital stay will be significantly prolonged,the incidence of pneumonia,bedsores,deep venous thrombosis and other complications will be significantly increased and the medical costs will be greatly increased.This is a heavy burden on hospitals,doctors,patients,and this medical insurance.Therefore,the researchers have done quite a lot of work on how to reduce the incidence of SSI after colorectal surgery,one of these themes is “Does high concentration of oxygen really reduce SSI after colorectal surgery?” This article will systematically review the effectiveness of the perioperative high-concentration supplemental oxygen therapy on prevention of surgical site infectionsObjectiveTo systematically review the effectiveness of the perioperative high-concentration supplemental oxygen therapy on prevention of surgical site infectionsMethods: A literature search was conducted using Pub Med,Embase,The Cochrane Library,CBM,CNKI,Wan Fang Data to collect randomized controlled trials about the effectiveness of the perioperative high-concentration supplemental oxygen on preventing of SSI which published until September 2017.Two reviewers evaluated the quality of literature independently and extracted data from each included study according to the selection criteria.Then we conducted Meta-analysis using Rev Man 5.3 and STATA 14 software.ResultsThis study included 8 randomized controlled trials with 2443 patients.Meta-analysis showed that perioperative supplement high concentration of oxygen can reduce the occurrence of SSI in patients underwent colorectal surgery RR = 0.80(95% CI: 0.66 to 0.96;P = 0.02).And when oxygen inhalation time was less than 2 hours,high concentration of oxygen could not reduce the occurrence of SSI.RR = 0.70(95% CI: 0.35-1.40;P = 0.32).When oxygen inhalation time was more than 6 hours,high concentration of oxygen could reduce the occurrence of SSI.RR = 0.57(95% CI: 0.37-0.87;P = 0.008).ConclusionPerioperative high-concentration supplemental oxygen can reduce the SSI rate.Give to the low-cost and low-risk characteristics of oxygen,we recommend supplemental 80% fraction of inspiration O2 during and at lest 6 hours after colorectal surgery.