Pressure-relieving properties of a intra-operative warming device

Up to 25% of all pressure ulcers that develop in hospitalised patients are thought to start in the operating theatre. Pressure-relieving mattresses and/or overlays are used in operating theatres to help prevent pressure damage to vulnerable areas such as the sacrum and heels, but there is no ‘standard’ theatre mattress and different mattresses give different degrees of pressure relief. Intra-operative warming may help to reduce the risk of pressure ulceration, although previous studies have produced conflicting results. This study investigated whether use of a warming device reduced sacral and heel interface pressures in 10 healthy volunteers; comparisons were made with a standard operating table mattress, a pressure-relieving gel pad and an under-patient warming device left switched on the operating table

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

Background 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. Methods 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. Finding 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) Interpretation 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

Surgical site infection - a European perspective of incidence and economic burden.

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