Patient warming excess heat: the effects on orthopedic operating room ventilation performance

Area of Science:

• Surgical Safety
• Operating Room Ventilation
• Medical Device Performance

Background:

• Patient warming is standard for preventing hypothermia in general surgery.
• Excess heat from warming devices may compromise sterile fields in contamination-sensitive surgeries by disrupting airflow.
• The impact of warming technologies on ventilation in orthopedic settings is not well understood.

Purpose of the Study:

• To evaluate the effect of forced air and conductive fabric patient warming systems on operating room ventilation.
• To assess potential contamination risks introduced by patient warming devices during orthopedic procedures.

Main Methods:

• A randomized design simulated a total knee replacement using a mannequin and anesthesia drape.
• Detergent bubbles tracked airflow disruption caused by forced air, conductive fabric, and control conditions.
• Bubble counts over the surgical site were quantified for low-drape and high-drape scenarios.

Main Results:

• Forced air warming significantly increased bubble counts (132.5 average) over the surgical site due to convection currents (P < 0.001).
• Conductive fabric warming (0.48 average) and control conditions (0.01 average) showed no significant difference in bubble counts (P = 0.87).
• Drape height did not significantly impact bubble counts (P = 0.94).

Conclusions:

• Forced air patient warming disrupts sterile field ventilation, increasing contamination risk.
• Conductive fabric patient warming does not significantly impact operating room airflow.
• Further research is needed on forced air warming's clinical impact in contamination-sensitive surgeries.