Outpatient Surgery Magazine

Special Outpatient Surgery Edition - Infection Control - May 2017

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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M A Y 2 0 1 7 O U T P A T I E N TS U R G E R Y. N E T 2 7 ies have involved placing agar plates around patients in the OR during cases when forced-air warming was used, but none of the results showed a definitive increase in bacteria load on the plates after surgery. Researchers have also looked at forced-air warming's impact on lami- nar airflow patterns in the OR during joint replacement procedures. If laminar flow is used, airflow around the surgical table should shoot straight down from the ceil- ing to the floor without bouncing back toward the wound. Some research has sug- gested forced-air warming interrupts the ideal laminar airflow, but a definitive link to SSI risk has not yet been shown in rigorous studies. The other issue is that cur- rent research assessing forced-air warming's impact on laminar airflow has been conducted in simulated settings without people moving around the OR table and without a door to an outside hallway opening and closing. Those aren't realistic methods for assessing unwanted airflow, so I'm not convinced the studies repre- sent real-life conditions. Effective testing needs to be done in a live operating room setting, but that would be difficult to accomplish. Some researchers have suggested the use of alternative warming methods dur- ing joint replacement procedures until more robust and definitive studies are con- ducted to assess the safety of forced-air warming, but have stopped short of con- demning the latter method. It's not unreasonable to follow that advice, but you must carefully consider the evidence suggesting forced-air warmers cause SSIs. Ultimately, it's up to you to stay current on the evidence independent researchers publish in peer-reviewed journals and keep an open mind about findings that touch on the safety and efficacy of patient warming. OSM Dr. Austin (paustin@txwes.edu) is a professor at Texas Wesleyan University in Fort Worth, Texas. • UNDER COVER Forced-air warming coverlets are disposable, light- weight and easy to apply.

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