NEWS: Simple Post-Op Test Predicts surgical site infection
http://www.outpatientsurgery.net/newsletter/eweekly/2010/10/12
Simple Post-Op Test Predicts SSIs
Testing a patient's tissue oxygen saturation level at the upper arm with near-infrared spectroscopy in the minutes following surgery may predict surgical site infection and may allow earlier preventive interventions, according to research published in the October 2010 issue of the journal Anesthesia and Analgesia.
Traditionally, an invasive, impractical subcutaneous tissue oxygen monitoring system is used to measure the level, say the study's authors. For this report, researchers employed a tissue oxygenation monitor that recorded the level as a measure of the blood's hemoglobin oxygen saturation illuminated by near-infrared light.
Researchers used the monitor to measure the level in 3 places - near the surgical incision, at the upper arm and at the thenar muscle - in patients who underwent elective colon resection. All patients were given prophylactic antibiotics within 1 hour before incision. The readings were taken 75 minutes after the end of surgery, enough time for patients to be weaned off supplemental oxygen, say the researchers.
Of the 116 patients enrolled in the study, 23 developed superficial incisional site infections an average of 9 days post-op, according to the findings. At 75 minutes post-op, the readings taken at the surgical incision site did not differ significantly between patients who developed SSIs and those that did not, say the researchers. However, they found that the readings taken at the upper arm were significantly lower in patients who developed post-op infections.
The link between tissue oxygenation and surgical wound infection is well-established, say the researchers, but using this "simple and noninvasive tissue oxygen monitoring system might be easier and more feasible for perioperative use" and could detect SSIs approximately 9 days before the infections are diagnosed clinically.
That early detection could give surgical teams the opportunity to employ interventions that improve tissue oxygenation, say the researchers, including reducing sympathetic nervous system activation by managing surgical pain, maintaining perioperative normothermia and administering supplemental fluid and oxygen.
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