Forced Air Warming Devices in Orthopaedics: A Focused Review of the Literature

Forced-Air Warming and Resistive Heating Devices. Updated Perspectives on Safety and Surgical Site Infections

“…Hypothermia during surgery can be generated by various factors such as: exposure to surgical environment, thermoregulatory dysfunction during general or regional anesthesia and medications. PH leads to intraoperative blood loss, cardiac events, coagulopathy, an increase in hospital stay and associated costs ( 1 , 2 ). Even mild hypothermia (approximately 2°C below normal temperature) can triple the incidence of wound infection and prolong hospitalization by about 20% ( 2 ).…”

“…PH leads to intraoperative blood loss, cardiac events, coagulopathy, an increase in hospital stay and associated costs ( 1 , 2 ). Even mild hypothermia (approximately 2°C below normal temperature) can triple the incidence of wound infection and prolong hospitalization by about 20% ( 2 ). Passive and active warming methods are used in the operating room (OR) to prevent the incidence of PH.…”

“…Currently, a plethora of patient warming devices are utilized to reduce the incidence of intraoperative hypothermia among surgical patients ( 2 , 3 ) (Table 1 ). We focus our review on two most commonly used and widely studied methods—forced air warming (FAW) and resistive heating (RH)—based on recent publications associated with their use ( 3 ).…”

“…RH system converts electrical energy into heat and warms the patient through conduction ( 2 ). Effective warming is delivered by non-disposable carbon polymer fiber fabric strips ( 7 , 8 ).…”

“…There is a concern that FAW device can increase the incidence of surgical site infections by disrupting the OR laminar air flow, ( 9 – 12 ) and by transporting contaminants from the floor to the sterile surgical field ( 13 ). Laminar flow ventilation is described as an entire body of highly filtered air (>99.997%) within a designated space (operating room) moving with uniform velocity (0.3 to 0.5 m/s) in unidirectional downward parallel flow ( 2 , 9 ). Laminar flow ventilation system reduces the number of contaminants in the OR air by generating a continuous flow of low bacteria containing air and sweeping the contaminants away from the surgical area ( 9 , 14 ).…”