hypothermia, but intraoperative warming alone isn't nearly as effec-
tive as actively warming patients both before and during surgery. A
June 2018 study in the Canadian Journal of Anesthesia
(osmag.net/a7rHME) compared 2 groups of patients, each of which
was warmed during the case with a forced-air warmer (FAW). One
group received a minimum of 30 minutes of pre-op FAW, while the
control group received a warmed blanket upon request.
Prewarmed patients had less hypothermia than those who were
only warmed during surgery. The key finding: Combining prewarming
with intraop warming is more effective at maintaining normothermia
than warming in the OR alone. While warming patients before and
during surgery is no guarantee against redistribution hypothermia,
researchers conclude that "their combined application results in
greater preservation of intraoperative normothermia compared with
intraoperative forced-air warming alone."
2. Does FAW increase the risk of infection?
While we're on
the subject of forced-air warming, let's address the controversy sur-
rounding it: the claim by some that FAW increases SSI risk by blowing
airborne particulate bacteria into the surgical field and depositing them
deep into patients' joints during total knee and hip replacements.
Research says it's a claim without merit. A December 2017 literature
review in Surgical Technology International found no evidence of an
increased SSI risk from FAW (osmag.net/Kj2QPw). Researchers, who
reviewed 8 studies reporting outcomes from nearly 2,000 patients,
were unequivocal in their conclusion: "There is no current evidence in
the orthopaedic literature that forced-air warming devices translate to
increased SSIs," they wrote. "Accordingly, these devices should continue
to be used for the maintenance of intraoperative normothermia."
The Food and Drug Administration likewise encouraged the contin-
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