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To the Editor: Dr Pryor and colleagues¹ reported that patients who received 80% inspired oxygen during and 2 hours after abdominal surgery had a significantly higher rate of surgical site infections (SSIs) than did those who received 35% oxygen. Although the authors controlled the concentration of inspired oxygen, they apparently did not consider other crucial factors such as fluid management, temperature, anesthetic management, and pain control. Tissue perfusion, and thus oxygenation, is often inadequate when these variables are not closely monitored and controlled.²

By contrast, Greif et al³ reported that 80% inspired oxygen decreased SSIs by 50%, after controlling for these other factors. Pryor et al did not report whether they attempted to optimize tissue perfusion, a factor recognized as critical by the US Centers for Disease Control and Prevention.⁴

There are a number of other problems with the study. For example, the sample is smaller and more heterogeneous than . . . [Full Text of this Article]

Harriet W. Hopf, MD
hhopf@itsa.ucsf.edu
Departments of Anesthesia, Perioperative Care, and Surgery

Thomas K. Hunt, MD
Department of Surgery
University of California, San Francisco

Noah Rosen, MD
Department of Surgery
Boston University Medical Center
Boston, Mass

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