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Mild perioperative hypothermia and the risk of wound infection
A Flores-Maldonado1, C E Medina-Escobedo, H M Ríos-Rodríguez
1Centro de Capacitación en Calidad, Instituto de Servicios Descentralizados de Salud Pública del Estado de Campeche (INDESALUD), Campeche, Mexico. afmaldonado@correoweb.com
Background:
Bacterial destruction caused by free radicals, which are synthesized by neutrophils in the presence of oxygen, depends on adequate tissue perfusion. Mild perioperative hypothermia causes vasoconstriction, reducing nutrient and oxygen supply to wounds and increasing frequency of surgical wound infection. However, the causal role of hypothermia in surgical wound infection is the subject of controversy. The present work proposes the hypothesis that mild perioperative hypothermia is associated with infection of the surgical wound.
Methods:
A prospective cohort of 290 surgical patients was studied in a second-level hospital; 261 (90%) of the patients concluded the follow-up. The relationship of hypothermia and of other confounding factors, such as diabetes mellitus, antibiotic treatment, and wound drains with infection outcome was evaluated. One physician, blinded to patient hypothermia, gathered the data. Surgical wound infection was defined as the surgeon's diagnosis with positive culture.
Results:
Twenty subjects (7.6%) showed infection of surgical wound; 18 (11.5%) of 156 hypothermics and two (2%) 105 normothermics (p = 0.004). Hypothermia proved to be a significant independent risk of infection with relative risk of 6.3 (p = 0.01).
Conclusions:
Mild perioperative hypothermia is associated with infection of the surgical wound and its prevention is therefore justified.
Insights
Mild perioperative hypothermia, a drop in body temperature during surgery, significantly increases the risk of surgical wound infections. Preventing hypothermia is crucial for better patient outcomes and reducing infection rates.
Area of Science:
- Surgical Infection Prevention
- Thermoregulation in Surgery
Background:
- Bacterial destruction relies on oxygen and nutrient supply, which can be compromised by hypothermia.
- Mild perioperative hypothermia may increase surgical wound infection risk, though this link is debated.
Purpose of the Study:
- To test the hypothesis that mild perioperative hypothermia is associated with surgical wound infection.
Main Methods:
- A prospective cohort study of 261 surgical patients was conducted.
- The relationship between perioperative hypothermia and surgical wound infection was analyzed, controlling for confounding factors.
- Surgical wound infection was confirmed by surgeon diagnosis and positive culture.
Main Results:
- Surgical wound infection occurred in 7.6% of patients (20/261).
- Hypothermic patients had a significantly higher infection rate (11.5%) compared to normothermic patients (2%) (p=0.004).
- Hypothermia was an independent risk factor for infection (Relative Risk=6.3, p=0.01).
Conclusions:
- Mild perioperative hypothermia is linked to surgical wound infection.
- Preventing perioperative hypothermia is clinically justified to reduce infection risk.