Editorial Commentary: Just Getting Warmed Up: Risks, Benefits, and Economics of Active Warming Devices

Efforts to maintain normothermia should be a part of every patient's perioperative care. Risks, benefits, and economic implications should be considered when deciding how to use active warming devices for orthopaedic surgery. The Centers for Medicare & Medicaid Services has implemented economic incentives and penalties driving hospitals to invest in active warming devices, including forced-air warmers and resistive heating devices. Even though forced-air warmers and resistive heating blankets are likely to statistically improve patient temperatures, they may not be worth the additional cost for shorter, less invasive, elective arthroscopic surgeries. In addition, recent research demonstrates minimal clinically significant differences between these 2 types of devices. Concern regarding possible increased risk of surgical-site contamination with forced-air warmers warrants further study but, again, is unlikely clinically relevant to arthroscopic cases, and proper staff training and warming equipment routine maintenance could minimize patient risk.