SP9.8 An Audit of Intraoperative Hypothermia Rates in Adults Undergoing Emergency Surgery in a Tertiary General Surgical Unit and Evaluation of the Efficacy of Preoperative and Intraoperative Forced-Air Warming on Achieving Intraoperative Normothermia

Abstract

Abstract Aims Surgical site infections (SSIs) inflict significant economic burden on the NHS. Preoperative and intraoperative hypothermia are risk factors for SSIs. Evidence shows that maintenance of intraoperative normothermia significantly reduces SSI rates. Perioperative SSI bundles addressing factors including hair removal, antibiotic prophylaxis, skin preparation, drape positioning, and hypothermia are critical to improving SSI rates. We aim to audit rates of intraoperative hypothermia in our surgical caseload and evaluate the efficacy of preoperative and intraoperative forced-air warming through bespoke gowns in achieving intraoperative normothermia. Methods We conducted a retrospective audit of the intraoperative core temperatures of all adult patients undergoing surgical procedures on the emergency theatre list of a general surgery department and who had a temperature at knife-to-skin recorded (n=88). We then ran a prospective trial, outfitting patients listed for surgery (n=15) with forced-air warming gowns. Patients underwent forced-air warming with the gowns for 45 minutes on the surgical ward, throughout anaesthetic induction, and intraoperatively. Patient core temperature was measured at baseline, upon arrival at the anaesthetic room, and at knife-to-skin. Results Baseline audit data showed over 18% of patients were hypothermic at knife-to-skin. Contrastingly, 100% of patients wearing forced-air warming gowns were normothermic at knife-to-skin. The mean core temperature at knife-to-skin was significantly higher in patients wearing warming gowns (p=0.012). Conclusions Forced-air warming gowns are superior to traditional hospital gowns, blankets and surgical access forced-air warming devices in achieving intraoperative normothermia. They are an effective, sustainable, and cost-neutral, ‘all-in-one’ alternative to current perioperative protocol and will reduce SSI rates.