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Effect of Peri-operative Supplemental Oxygen in Wound Infection After Appendectomy

Not Applicable
Completed
Conditions
Wound Infection
Perioperative Hyperoxygenation
Interventions
Registration Number
NCT02687217
Lead Sponsor
Lady Hardinge Medical College
Brief Summary

The study evaluates the role of supplemental hyper-oxygenation given perioperatively on wound site infection after appendectomy. Half of the patients received ≥50% oxygen and half of them received no oxygen during the surgical procedure.

Detailed Description

Patient with the diagnosis of acute appendicitis of \>15 years of age group, with no comorbidities who presented to surgical emergency in Dr. Ram Manohar Lohia Hospital were considered for the present study.

30 patients who fulfilled the inclusion criteria and who voluntarily consented for the study were randomly allocated to the two groups- Group A (control group) and Group B (study group).

These patients were operated through Mc-Burney incision given in the right lower quadrant.

Both the groups were comparable in their demographic and preoperative profile. The study group was given ≥50% of oxygen intraoperatively and the control group was given no oxygen.

In postoperative period, oxygen was given to group A at the rate of 4 litre/minute (L/min) and group B at the rate of 6 litre/minute (L/min).

The assessment of the wound was done by using ASEPSIS (Additional treatment; Serous discharge; Erythema; Purulent exudate; Separation of deep tissues; Isolation of bacteria; and Stay) score. A score of more than 20 is considered to be infected.

Fever, raised total leucocyte count, positive pus culture, Ultrasound evidence of fluid collections, removal of sutures and duration of hospital stay were also measured for the evaluation of economic implications due to SSI.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
60
Inclusion Criteria
  1. Clinical diagnosis or Radiological diagnosis of acute appendicitis.
  2. Appendectomy through the Mc Burney incision.
Exclusion Criteria
  1. Patients with chronic obstructive pulmonary diseases.
  2. Immunodeficiency disease.
  3. Patients requiring midline incision.
  4. Patients requiring general anaesthesia after failure of spinal anaesthesia.
  5. Patients requiring higher oxygen in perioperative period.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Group B: TestoxygenGroup B: Test- Received hyperoxygenation more than or equal to 50% throughout the surgery and received oxygen at 6l/min. upto 2 hrs postoperatively.
Primary Outcome Measures
NameTimeMethod
ASEPSIS Score14 days

ASEPSIS score- Additional treatment; Serous discharge; Erythema; Purulent exudate; Separation of deep tissues; Isolation of bacteria; and Stay. A daily score of 20 or more considered evidence of infection.

Category of infection:

Total score of 0-10 satisfactory healing; 11-20 disturbance of healing; 21-30 minor wound infection; 31-40 moderate wound infection; \> 40 severe wound infection.

Secondary Outcome Measures
NameTimeMethod
Number of Patients Requiring Additional Investigations14 days

Sonography; Pus culture; blood culture; Total Leucocyte Count.

Number of Patients Requiring Additional Treatment14 days

Requirement of antipyretics; increased dose/ duration of antibiotic usage other than standard protocol; need for change to higher antibiotics; requirement of drainage procedures for pus/ wound infections; requirement for additional dressing sessions

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