Hypothermia Is Associated with Surgical Site Infection in Cytoreductive Surgery with Hyperthermic Intra-Peritoneal Chemotherapy

Abstract

Hypothermia is associated with the development of SSIs in patients undergoing CRS/HIPEC. Our findings suggest that minimizing peri-operative temperatures to less than 36.0°C may decrease peri-operative SSI in this patient population.

The Role of Perioperative Hypothermia in the Development of Surgical Site Infection: A Systematic Review

“…With the exception of one prospective study in Japan, 29 the studies were conducted in the United States and had a retrospective design 6,8,9,20,27,28 . Most of the studies included patients who underwent a surgical procedure at a single center (ie, hospital) under general anesthesia 6,8,20,27,28 and included a variety of open procedures 6,8,9,20,27,28 . One group of researchers reviewed records from four surgical facilities 9 and another group of researchers studied emergent procedures 27 .…”

“…One group of researchers reviewed records from four surgical facilities 9 and another group of researchers studied emergent procedures 27 . The seven studies included a total of 7,746 participants; the number of participants in each study ranged from 170 28 to 3,628 8 . The mean age of the participants ranged from 30.9 (standard deviation [SD] = 12.4) years 27 to 69.0 (SD = 11.0) years 6 .…”

“…The operative time varied between a minimum of 1.5 hours 8 and a maximum of 10.3 hours 28 . In four studies, researchers considered the long duration of surgery to be a contributing factor for the development of SSI 6,8,27,28 . Tsuchida et al 29 provided data in a table that indicated prolonged length of surgery was a risk factor for SSI but did not discuss the relationship.…”

“…We excluded studies on pediatric patients, reviews, and articles that had been accepted but not yet published. As a result, seven articles met the specified criteria 6,8,9,20,27-29 …”

“…However, the literature contains contradictory data on the association of perioperative hypothermia and the risk of SSI 26 . Although some researchers suggest that perioperative hypothermia is an important risk factor for SSI, 25,27,28 other researchers did not identify hypothermia as an independent risk factor for SSI development 6,9,20,29 . Some researchers did not include hypothermia when they examined the SSI risk factors 23,30,31 .…”