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in outpatient settings. Maintaining adequate oxygen delivery (DO ) after major surgery is associated with minimising organ dysfunction. Skin is particularly vulnerable to reduced DO . We tested the hypothesis that reduced perioperative DO fuels inflammation in metabolically compromised skin after major surgery. Participants undergoing elective oesophagectomy were randomised immediately after surgery to standard of care or haemodynamic therapy to achieve their individualised preoperative DO . Abdominal punch s