Perioperative warming therapy for preventing surgical site infection in adults undergoing surgery

Ousey, Karen; Edward, Karen‐Leigh; Lui, Steve; Stephenson, John; Duff, Jed; Walker, Kim; Leaper, David

doi:10.1002/14651858.cd011731

Cited by 4 publications

(6 citation statements)

References 33 publications

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“…Passive and active warming methods are used in the operating room (OR) to prevent the incidence of PH. Blanket use to provide insulation and radiant heat loss prevention (passive method), warming intravenous fluids, and patient warming devices (active methods) are well known ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

“…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 ).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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Introduction: Perioperative hypothermia is one of the most common phenomena seen among surgical patients, leading to numerous adverse outcomes such as intraoperative blood loss, cardiac events, coagulopathy, increased hospital stay and associated costs. Forced air warming (FAW) and resistive heating (RH) are the two most commonly used and widely studied devices to prevent perioperative hypothermia. The effect of FAW on operating room laminar flow and surgical site infection is unclear and we initiated an extensive literature search in order to get a scientific insight of this aspect.Material and Methods: The literature search was conducted using the Medline search engine, PubMed, Cochrane review, google scholar, and OSU library.Results: Out of 92 Articles considered initially for review we selected a total of 73 relevant references. Currently there is no robust evidence to support that FAW can increase SSIs. In addition, both of the two warming devices present safety problems.Conclusion: As unbiased independent reviewers, we advise clinicians to weigh the risks and benefits when using either one of these devices; no change in the current practice is necessary until further data emerges.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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“…Among them, forced warming device and device using conduction are currently mainly used as patient warming devices. 4 Although these warming devices are known to be effective in preventing hypothermia, they had to be used around the surgical field, causing many concerns about their relationship with surgical site infection (SSI). [2][3][4] However, there are still many controversies about the effect of these active warming devices on the rate of SSI after surgery.…”

Section: Neurospine Eissn 2586-6591 Pissn 2586-6583mentioning

confidence: 99%

“…4 Although these warming devices are known to be effective in preventing hypothermia, they had to be used around the surgical field, causing many concerns about their relationship with surgical site infection (SSI). [2][3][4] However, there are still many controversies about the effect of these active warming devices on the rate of SSI after surgery. 5,6 In addition, there has been no study on the association in posterior spinal fusion surgery, which is performed in a relatively large number compared to other spinal surgeries but has a higher SSI rate.…”

Section: Neurospine Eissn 2586-6591 Pissn 2586-6583mentioning

confidence: 99%

Relationship Between Types of Warming Devices and Surgical Site Infection in Patients Who Underwent Posterior Fusion Surgery Based on National Data

Kim,

Cha,

Seok

et al. 2023

Neurospine

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Objective: Perioperative hypothermia can lead to various complications. Although various warming techniques have been used to prevent perioperative hypothermia, the effect of these techniques on surgical site infection (SSI) during posterior fusion surgery is unclear. The effects of warming devices on SSI rates were therefore analyzed using data complied by the Health Insurance and Review Assessment (HIRA) Service in Korea.Methods: This study included 5,406 patients in the HIRA Service database who underwent posterior fusion surgery during the years 2014, 2015, and 2017. Factors related to SSI in these patients, including warming devices, antibiotics, and transfusion, were analyzed.Results: The incidence of SSI was higher in patients who underwent forced air warming than in those who did not undergo active warming (odds ratio [OR], 1.73; p = 0.039), especially above 70 years old (OR, 4.11; p = 0.014). By contrast, the incidence of SSI was not significantly higher in patients who underwent device using conduction. Infection rates were higher in patients who received prophylactic antibiotics within 20 minutes before incision, than within 21 to 60 minutes (OR, 2.07; p = 0.001) and who received more blood transfusions (1 pint < volume ≤ 2 pint; OR, 1.75; p = 0.008, > 2 pint; OR, 2.73; p = 0.004).Conclusion: SSI rates were higher in patients who underwent warming with forced air devices than with devices using conduction, as well as being higher in patients who older age, received blood transfusions and administered antibiotics within 20 minutes before incision. Devices using conduction have more advantages in preventing SSI than forced air warming device. In addition, the reduction of other risk factors for SSI may improve postoperative results.

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“…Alongside relatively lacking clinical literature relating warming interventions directly against SSI presentation and related patient recovery measures, existing studies have also yielded conflicting conclusions. Most recently in 2015, Ousey et al 15 concluded that while both active and passive perisurgical warming conferred significant benefits toward some reduction in short-term inpatient SSI recordings, follow-up tracking data suggested that these benefits disappeared when evaluated by more longitudinal factors such as SSI-related hospitalisations, further acute exacerbation, or long-term morbidity and mortality of attributable cause. Contemporary research from paediatric spine procedures indicate that surgical warming interventions significantly reduce postoperative bleeding and blood transfusion volume but generally fail to produce meaningful decreases in patient-centred results, including SSI severity and length of admittance.…”

Section: Introductionmentioning

confidence: 99%

Utility of Perioperative Warming for the Prevention of Surgical Site Infection and Patient Rehabilitative Complications: A Systematic Review

Shang

Galow

Essuman³

2020

EMJ Innov

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Overview: Surgical site infection (SSI) is a leading cause of postoperative complication, rehospitalisation, and patient mortality after invasive clinical interventions. Surgical risks compounded by SSI introduce greater medical, economic, and quality-of-life challenges for both patients and providers alike, and to better inform clinical practice, empirical evaluation of modern surgical warming techniques is relevant. This systematic review and meta-analysis qualitatively examined the efficacy of both active and passive perioperative warming interventions upon SSI presentation versus standardised (i.e., non-warming) care. Methods: This review analysed available literature on active and passive warming application across general anaesthesia procedures, containing longitudinal data on patient outcomes and SSI. The primary outcome studied was occurrence of post-surgical SSI; secondary outcomes included rehabilitative length of stay, attributable SSI-related mortality, and incidence of re-admittance. Results: Meta-analysis demonstrated a significantly reduced risk ratio for SSI in patients receiving any surgical warming intervention (odds ratio: 0.36; 95% confidence interval: 0.18–0.87; p<0.01) compared to individuals treated under standard care conditions, with limited further data supporting improved active warming effect in contrast with passive implementation. Secondary postoperative outcomes, including length of rehabilitative stay or wound healing score (ASEPSIS), correspondingly demonstrated greater outcomes for surgical patients receiving perioperative warming. Introduction of warming interventions consistently correlated with reduced patient-reported pain experiences (p<0.05) and downstream care expenditures (p<0.01). Conclusion: The present review identified evidence supporting a statistically significant correlation between both active and passive perioperative warming interventions to SSI prevention. These findings strongly support the recommendation of standardised perioperative warming implementation with continued investigation of relative efficacy contrasting active and passive methodologies, and across more diverse and substantial patient population sizes.

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Perioperative warming therapy for preventing surgical site infection in adults undergoing surgery

Abstract: Perioperative warming therapy for preventing surgical site infection in adults undergoing surgery.

Cited by 4 publications

References 33 publications

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

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

Relationship Between Types of Warming Devices and Surgical Site Infection in Patients Who Underwent Posterior Fusion Surgery Based on National Data

Utility of Perioperative Warming for the Prevention of Surgical Site Infection and Patient Rehabilitative Complications: A Systematic Review

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