Forced Air Warming Devices in Orthopaedics: A Focused Review of the Literature
第一作者:Robby S. Sikka
2015-01-07 点击量:612 我要说
Robby S. Sikka,Richard C. Prielipp
The current focus on maintaining normal body temperature in the operating room makes the use of patient warming devices routine—or even mandatory—in many hospitals. Forced air warming devices such as the Bair Hugger (3M Healthcare, St. Paul, Minnesota) maintain or increase core temperature in patients during the perioperative period, with benefits that include reduced surgical wound infections, maintenance of normal coagulation, and faster discharge from the post-anesthesia care unit (PACU). However, some recent literature has raised concerns regarding a possible increased risk of deep surgical site infections specifically associated with the use of the forced air warming systems in the orthopaedic operating room. One concern is that a convective device could disrupt unidirectional downward laminar airflow, which may be especially critical in joint arthroplasty operating rooms. This concern is based on theoretical mechanisms, laboratory simulations, retrospective case series, and studies showing potentially pathogenic organisms growing in the hoses and filters of forced air warming devices. However, multiple other studies and a Continuing Education statement by the Association of periOperative Registered Nurses (AORN) suggest that proper use of the forced air warming devices mitigates or eliminates this risk while maximizing the benefits of patient warming. The purpose of the present manuscript is to review the current literature on the use of patient warming devices in orthopaedic surgery, specifically in joint arthroplasty.