XXXX decreases perioperative tissue oxygenation.

@entity1 @entity6081 @entity28 @entity26 @entity519
BACKGROUND: @entity28 is an important risk factor for surgical site infections. The incidence of @entity6081 is directly related to tissue perfusion and oxygenation. Fat tissue mass expands without a concomitant increase in blood flow per cell, which might result in a relative hypoperfusion with decreased tissue oxygenation. Consequently, the authors tested the hypotheses that perioperative tissue @entity26 tension is reduced in @entity28 surgical @entity1 . Furthermore, they compared the effect of supplemental @entity26 administration on tissue oxygenation in @entity28 and nonobese @entity1 . METHODS: Forty-six @entity1 undergoing major abdominal surgery were assigned to one of two groups according to their body mass index: body mass index less than 30 kg/m2 (nonobese) or 30 kg/m2 or greater ( @entity28 ). Intraoperative @entity26 administration was adjusted to arterial @entity26 tensions of approximately 150 mmHg and approximately 300 mmHg in random order. Anesthesia technique and perioperative fluid management were standardized. Subcutaneous tissue @entity26 tension was measured with a polarographic electrode positioned within a subcutaneous tonometer in the lateral upper arm during surgery, in the recovery room, and on the first postoperative day. Postoperative tissue @entity26 was also measured adjacent to the wound. Data were compared with unpaired two-tailed t tests and Wilcoxon rank sum test; P < 0.05 was considered statistically significant. RESULTS: Intraoperative subcutaneous tissue @entity26 tension was significantly less in the @entity28 @entity1 at baseline (36 vs. 57 mmHg; P = 0.002) and with supplemental @entity26 administration (47 vs. 76 mmHg; P = 0.014). Immediate postoperative tissue @entity26 tension was also significantly less in subcutaneous tissue of the upper arm (43 vs. 54 mmHg; P = 0.011) as well as near the incision (42 vs. 62 mmHg; P = 0.012) in @entity28 @entity1 . In contrast, tissue @entity26 tension was comparable in each group on the first postoperative morning. CONCLUSION: Wound and tissue @entity519 were common in @entity28 @entity1 in the perioperative period and most pronounced during surgery. Even with supplemental @entity26 tissue, @entity26 tension in @entity28 @entity1 was reduced to levels that are associated with a substantial increase in infection risk.
