Convective Warming Therapy Does Not Increase the Risk of Wound Contamination in the Operating Room

Forced‐Air Warming Devices and the Risk of Surgical Site Infections

“…Our search yielded a total of 192 possible sources. Fifteen sources 5‐19 remained after we eliminated those that were duplicates or did not meet our inclusion criteria. We did not find any systematic reviews.…”

“…The investigations we reviewed used four general methods to determine the likelihood of the forced‐air warmer causing an SSI, with some studies using more than one method. The direct method was to follow patients who were warmed intraoperatively with a forced‐air warmer to determine whether it led to an increased incidence of SSI, 12,14,15 and the three indirect methods were to examine the intake, inside, and output hoses of forced‐air warming units or the air emitted directly from the forced‐air warming unit for bacteria or particles that might harbor bacteria 5‐8,10,12 ; evaluate bacterial counts near or on patients, volunteers, or manikins in an OR 12,15,17‐19 ; and examine unwanted airflow disturbances in the OR caused by the forced‐air warming device 9,11,13,14,16,17 It is important to note that only one of these methods, which was used in three investigations, directly examined the likelihood of an increased incidence of SSIs caused by the intraoperative use of forced‐air warmers 12,14,15 .…”

“…There were numerous methodological concerns with all of the investigations that we reviewed 5‐19 . For example, none of the researchers described how they determined the sample size of forced‐air warmers or the number of study participants.…”

“…The second indirect method used 12,15,17‐19 to determine whether forced‐air warmers are likely to cause SSIs was to examine bacterial counts near or on patients 12,15,18 or volunteers 17,19 or near where the site of surgery would most likely be in an empty OR 17 (Table 3). Researchers obtained samples from the surgical site, 12,15,19 near the surgical site, 17 and close to the middle of the OR 18 . The investigators clearly described the methods used to gather samples and culture bacteria.…”

Perioperative Medical Management for Total Joint Arthroplasty

“…The authors concluded further work is required to confi rm that unidirectional airfl ow produced by LAF is disrupted by FAW devices as they did not study airfl ow over the surgical site. On the other hand, several studies on this subject have failed to link FAW systems to a direct increase in bacterial air counts and/or SSI (Moretti et al 2009 ;Tumia and Ashcroft 2002 ;Zink and Iaizzo 1993 ). Moretti et al studied the risk of surgical site contamination by Bair Hugger blankets in 30 THR surgeries.…”