This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on Web of Science (1)  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Surgery  • Surgical Physiology  • Surgical Infections  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Dr Pryor and colleagues¹ did not measure oxygenation of peri-incisional fatty tissue, which is an important mediator of wound-space oxygenation and the resulting oxygen-dependent killing of bacteria by local neutrophils.² To isolate a potential effect of increased inspired oxygen on local wound defenses, it is also important to prevent peripheral vasoconstriction, both by volume expansion and also by warming to avoid blunting of reflex vasoconstriction as patients emerge from general anesthesia.³ Unfortunately, Pryor et al did not describe details of fluid management or warming. Furthermore, simple volume expansion may improve fat oxygenation by as much as 25% without administration of extra oxygen.⁴ Inadequate pain control may also play an important role in stimulating sympathetic discharge; the resultant peripheral vasoconstriction need not be massive to influence fat perfusion and thus oxygenation.⁵

Finally, patients who received the higher oxygen concentration were more likely to be obese. Such patients may . . . [Full Text of this Article]

James T. Lee, MD, PhD
jtlmd@blackhole.com
Veterans Affairs Medical Center
Minneapolis, Minn

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Supplemental Oxygen and Risk of Surgical Site Infection
Harriet W. Hopf, Thomas K. Hunt, and Noah Rosen
JAMA. 2004;291(16):1956.
EXTRACT | FULL TEXT  

Supplemental Oxygen and Risk of Surgical Site Infection
Ozan Akça and Daniel I. Sessler
JAMA. 2004;291(16):1956-1957.
EXTRACT | FULL TEXT  

Supplemental Oxygen and Risk of Surgical Site Infection
Robert Greif and Daniel I. Sessler
JAMA. 2004;291(16):1957.
EXTRACT | FULL TEXT  

Supplemental Oxygen and Risk of Surgical Site Infection
Johann Harten, Keith Anderson, and John Kinsella
JAMA. 2004;291(16):1957.
EXTRACT | FULL TEXT  

Supplemental Oxygen and Risk of Surgical Site Infection
Martin J. O'Neill, Jr
JAMA. 2004;291(16):1958.
EXTRACT | FULL TEXT  

Supplemental Oxygen and Risk of Surgical Site Infection—Reply
Kane O. Pryor, Thomas J. Fahey, III, Cynthia A. Lien, and Peter A. Goldstein
JAMA. 2004;291(16):1958-1959.
EXTRACT | FULL TEXT  

Surgical Site Infection and the Routine Use of Perioperative Hyperoxia in a General Surgical Population: A Randomized Controlled Trial
Kane O. Pryor, Thomas J. Fahey, III, Cynthia A. Lien, and Peter A. Goldstein
JAMA. 2004;291(1):79-87.
ABSTRACT | FULL TEXT