Safety and efficacy of resistive polymer versus forced air warming in total joint surgery

Sandoval, Melanie F.; Mongan, Paul D.; Dayton, Michael R.; Hogan, Craig

doi:10.1186/s13037-017-0126-0

Cited by 14 publications

(11 citation statements)

References 13 publications

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“…Hypothermia, which is defined as a core body temperature below 36°C [8], is a common event during operations due to the impacts of anesthetics and prolonged skin exposure to the cool environment of the operation room. It is also related to thermal discomfort, increased risk of cardiac morbidity, higher rates of surgical site infections, prolonged effects of anesthetics, and increased length of hospital stay [3,9,10].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Intraoperative Hypothermia on Blood Loss and Allogenic Blood Transfusion in Total Knee and Hip Arthroplasty: A Retrospective Study

Pan

Song

Yao

et al. 2020

BioMed Research International

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Background. Total joint arthroplasty (TJA) usually leads to substantial blood loss, which may cause allogenic blood transfusion. Hypothermia occurring during operation has been reported to increase blood loss and transfusion rates in nonorthopedic cohorts. However, the relationship between intraoperative hypothermia and blood loss remains controversial in patients undergoing orthopedic surgeries. The aims of this study were to investigate the incidence of hypothermia and identify the impact of intraoperative body temperature and hypothermia on blood loss and transfusion rates in total knee and hip arthroplasty (TKA and THA, respectively). Methods. This retrospective study enrolled 616 consecutive patients, who underwent primary unilateral TKA or THA at our institution during the period from April 2012 to July 2014. The occurrence of a temperature below 36°C during the operation was documented to identify the incidence of hypothermia. Univariate analysis was performed to find the risk factors for hypothermia. Multiple regression analysis and multivariate logistic regression analysis were employed to explore the association of intraoperative temperature and hypothermia with intraoperative blood loss and perioperative blood transfusion. Results. The incidence of intraoperative hypothermia was 13.5%, 14.0%, and 13.1% in TJA, TKA, and THA, respectively. Intraoperative temperature (P=0.045, P=0.006) and hypothermia (P=0.042, P<0.001) were associated with intraoperative blood loss and perioperative transfusion in TKA. Intraoperative temperature (P=0.002) was negatively related to the amount of blood loss, and hypothermia (P=0.031) was the independent risk factor for transfusion in THA. Conclusion. Intraoperative hypothermia is associated with increased blood loss and transfusion rates in TJA. Efforts should be made to maintain normothermia during operation in these patients.

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Section: Introductionmentioning

confidence: 99%

The Impact of Intraoperative Hypothermia on Blood Loss and Allogenic Blood Transfusion in Total Knee and Hip Arthroplasty: A Retrospective Study

Pan

Song

Yao

et al. 2020

BioMed Research International

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“…No burns due to the use of EasyWarm V R or overheating were observed in our study, as was also the case in the multicentre trial by Torossian et al 11 Nosocomial infection, especially at the surgical site due to disturbance of laminar air flow caused by FAW devices, has been a concern, particularly in orthopaedic surgery, and studies have conflicting results. [16][17][18][19] Use of EasyWarm V R blankets might be a preferable option for such cases. It may also be valuable in intra-and interhospital transfers.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the EasyWarm® self-heating blanket with the Cocoon forced-air warming blanket in preventing intraoperative hypothermia

Thapa

Kerton

Peyton

2019

Anaesth Intensive Care

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The importance of preventing hypothermia in the perioperative period cannot be overemphasised. The use of active warming devices is advocated and practised widely. The forced-air warming (FAW) blanket is currently a popular modality. The BARRIER V R EasyWarm V R (M€ olnlycke Healthcare, Belrose, Australia) self-heating blanket, which does not require a power unit, has been proposed as an easy-to-use alternative to the FAW blanket. We conducted a singlecentre, randomized controlled trial to compare the efficacy of the EasyWarm V R self-heating blanket to the Cocoon blanket (Care Essentials, North Geelong, Australia), a conventional FAW blanket, in preventing intraoperative hypothermia. Forty patients undergoing elective surgery under general anaesthesia lasting >1 h were randomized in a 1:1 ratio. Prewarming was not allowed; 39 patients were analysed (19 EasyWarm V R group and 20 Cocoon blanket group). There was no statistically significant difference between the two groups with regard to the mean (AEstandard deviation) final nasopharyngeal temperature (35.89 AE 0.82 C versus 35.74 AE 0.77 C; P ¼ 0.72 in the Cocoon and EasyWarm V R blanket groups, respectively). Similarly, the difference between average temperatures at 1, 2 and 3 h was not statistically significant. We found the EasyWarm V R blanket to be as effective as the Cocoon FAW blanket in preventing intraoperative hypothermia. Due to its ease of use, the EasyWarm V R blanket may have an additional benefit in preoperative warming of patients.

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“…During their surgery, the participant is kept warm as part of their standard care using the technology to which they have been assigned. Both FAW and RFW are licenced and established techniques and are equally effective at preventing IPH [ 32 – 34 ]. Both warming devices are used in accordance with national guidelines as defined in NICE CG65.…”

Section: Methodsmentioning

confidence: 99%

Reducing Implant Infection in Orthopaedics (RIIiO): a pilot study for a randomised controlled trial comparing the influence of forced air versus resistive fabric warming technologies on postoperative infection rates following orthopaedic implant surgery in adults

Kümin

Harper

Reed

et al. 2018

Trials

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BackgroundApproximately 70,000 to 75,000 proximal femoral fracture repairs take place in the UK each year. Hemiarthroplasty is the preferred treatment for adults aged over 60 years. Postoperative infection affects up to 3% of patients and is the single most common reason for early return to theatre. Ultraclean ventilation was introduced to help mitigate the risk of infection, but it may also contribute to inadvertent perioperative hypothermia, which itself is a risk for postoperative infection. To counter this, active intraoperative warming is used for all procedures that take 30 min or more. Forced air warming (FAW) and resistive fabric warming (RFW) are the two principal techniques used for this purpose; they are equally effective in prevention of inadvertent perioperative hypothermia, but it is not known which is associated with the lowest infection rates. Deep surgical site infection doubles operative costs, triples investigation costs and quadruples ward costs. The Reducing Implant Infection in Orthopaedics (RIIiO) study seeks to compare infection rates with FAW versus RFW after hemiarthroplasty for hip fracture. A cost-neutral intervention capable of reducing postoperative infection rates would likely lead to a change in practice, yield significant savings for the health economy, reduce overall exposure to antibiotics and improve outcomes following hip fracture in the elderly. The findings may be transferable to other orthopaedic implant procedures and to non-orthopaedic surgical specialties.MethodsRIIiO is a parallel group, open label study randomising hip fracture patients over 60 years of age who are undergoing hemiarthroplasty to RFW or FAW. Participants are followed up for 3 months. Definitive deep surgical site infection within 90 days of surgery, the primary endpoint, is determined by a blinded endpoint committee.DiscussionHemiarthroplasty carries a risk of deep surgical site infection of approximately 3%. In order to provide 90% power to demonstrate an absolute risk reduction of 1%, using a 5% significance level, a full trial would need to recruit approximately 8630 participants. A pilot study is being conducted in the first instance to demonstrate that recruitment and data management strategies are appropriate and robust before embarking on a large multi-centre trial.Trial registrationISRCTN, ISRCTN74612906. Registered on 27 February 2017.Electronic supplementary materialThe online version of this article (10.1186/s13063-018-3011-y) contains supplementary material, which is available to authorized users.

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Safety and efficacy of resistive polymer versus forced air warming in total joint surgery

Cited by 14 publications

References 13 publications

The Impact of Intraoperative Hypothermia on Blood Loss and Allogenic Blood Transfusion in Total Knee and Hip Arthroplasty: A Retrospective Study

The Impact of Intraoperative Hypothermia on Blood Loss and Allogenic Blood Transfusion in Total Knee and Hip Arthroplasty: A Retrospective Study

Comparison of the EasyWarm® self-heating blanket with the Cocoon forced-air warming blanket in preventing intraoperative hypothermia

Reducing Implant Infection in Orthopaedics (RIIiO): a pilot study for a randomised controlled trial comparing the influence of forced air versus resistive fabric warming technologies on postoperative infection rates following orthopaedic implant surgery in adults

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