Preoperative Warming Research Articles

Preoperative combined with intraoperative skin-surface warming avoids hypothermia caused by general anesthesia and surgery

Study objectives To evaluate the effects of intraoperative skin-surface warming with and without 1 hour of preoperative warming, in preventing intraoperative hypothermia, and postoperative hypothermia, and shivering, and in offering good conditions to early tracheal extubation. Design Prospective, randomized, blind study. Setting Teaching hospital. Patients 30 ASA physical status I and II female patients scheduled for elective abdominal surgery. Interventions Patients received standard general anesthesia. In 10 patients, no special precautions were taken to avoid hypothermia. Ten patients were submitted to preoperative and intraoperative active warming. Ten patients were only warmed intraoperatively. Measurements and main results Temperatures were recorded at 15-minute intervals. The patients who were warmed preoperatively and intraoperatively had core temperatures significantly more elevated than the other patients during the first two hours of anesthesia. All patients warmed intraoperatively were normothermic only at the end of the surgery. The majority of the patients warmed preoperatively and intraoperatively or intraoperatively only were extubated early, and none had shivering. In contrast, five unwarmed patients shivered. Conclusions One hour of preoperative warning combined with intraoperative skin-surface warming, not simply intraoperative warming alone, avoided hypothermia caused by general anesthesia during the first two hours of surgery. Both methods prevented postoperative hypothermia and shivering and offered good conditions for early tracheal extubation.

Prevention of postsurgical infections: some like it hot

Purpose of the review The present review covers the literature on prevention of surgical site infections published during 2001. Only papers that offer new insights or question current recommendations are included. Recent findings The most interesting advances have been made in the preoperative preparation of the patient. In particular, the effects of preoperative warming of the patient, either generally or locally at the incision site, on the rate of surgical site infections are impressive and warrant further investigation. Also, the effects of strict control of perioperative blood glucose levels and of preoperative eradication of nasal carriage of Staphylococcus aureus should be studied in greater detail. Summary The protective effect of local and systemic warming before surgical procedures has been described in two well designed studies. Although a final judgement regarding effectiveness can only be made after more extensive investigations have been conducted, there appear to be few arguments against application of this cheap and safe measure. Thus, implementation of preoperative warming can be justified in settings associated with high rates of surgical site infections.

Prevention of postsurgical infections: some like it hot.

The present review covers the literature on prevention of surgical site infections published during 2001. Only papers that offer new insights or question current recommendations are included. The most interesting advances have been made in the preoperative preparation of the patient. In particular, the effects of preoperative warming of the patient, either generally or locally at the incision site, on the rate of surgical site infections are impressive and warrant further investigation. Also, the effects of strict control of perioperative blood glucose levels and of preoperative eradication of nasal carriage of Staphylococcus aureus should be studied in greater detail. The protective effect of local and systemic warming before surgical procedures has been described in two well designed studies. Although a final judgement regarding effectiveness can only be made after more extensive investigations have been conducted, there appear to be few arguments against application of this cheap and safe measure. Thus, implementation of preoperative warming can be justified in settings associated with high rates of surgical site infections.

Warming patients before clean surgery reduced the incidence of postoperative wound infection

(2001) Lancet 358, 876. Melling AC, Ali B, Scott EM . , et al. . Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomised...

Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomized controlled trial.

Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomized controlled trial.

World literature review

Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomised control trial.

World literature review

Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomised control trial.

Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomised controlled trial

Wound infection after clean surgery is an expensive and often underestimated cause of patient morbidity, and the benefits of using prophylactic antibiotics have not been proven. Warming patients during colorectal surgery has been shown to reduce infection rates. We aimed to assess whether warming patients before short duration, clean surgery would have the same effect. 421 patients having clean (breast, varicose vein, or hernia) surgery were randomly assigned to either a non-warmed (standard) group or one of two warmed groups (local and systemic). We applied warming for at least 30 min before surgery. Patients were followed up and masked outcome assessments made at 2 and 6 weeks. Analysis was done on an intention-to-treat basis. We identified 19 wound infections in 139 non-warmed patients (14%) but only 13 in 277 who received warming (5%; p=0.001). Wound scores were also significantly lower (p=0.007) in warmed patients. There was no significant difference in the development of haematomas or seromas after surgery but the non-warmed group were prescribed significantly more postoperative antibiotics (p=0.002). Warming patients before clean surgery seems to aid the prevention of postoperative wound infection. If applied according to the manufacturers guidelines these therapies have no known side-effects and might, with the support of further studies, provide an alternative to prophylactic antibiotics in this type of surgery.

World literature review

Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomised control trial.

Survival of Streptococcus Viridans in Gentamicin-Supplemented McCarey-Kaufman Medium

Our experience with three cases of Streptococcus viridans endophthalmitis, following penetrating keratoplasty, prompted us to investigate the ability of gentamicin-supplemented McCarey-Kaufman (M-K) medium to kill S. viridans contaminants. After inoculation of 20 cc of gentamicin-supplemented M-K with S. viridans, the M-K was exposed to temperature conditions similar to those that would be encountered by a donor cornea during storage (4 degrees C) and preoperative warming prior to keratoplasty (23 degrees C). Colony counts were performed at regular intervals. After 1 h of warming, no reduction in the initial inoculum had occurred. This is in contrast to results from similar experiments with Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa in which more than 1 log unit of killing occurred after 1 h. While previously reported clinical experience has demonstrated an overall low incidence of postkeratoplasty endophthalmitis using gentamicin-supplemented M-K, our own recent clinical and laboratory data suggest that additional or alternate antibiotic coverage for S. viridans may be prudent.