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The influence of operating room temperature and humidity on surgical site infection: A multisite ACS-NSQIP analysis
Jacob B Hammond1, Grace M Madura1, Yu-Hui H Chang2
1Department of Surgery, Mayo Clinic, Phoenix, AZ, USA.
Background:
Literature evaluating intraoperative temperature/humidity and risk of surgical site infection (SSI) is lacking.
Methods:
All operations at three centers reported to the ACS-NSQIP were reviewed (2016-2020); ambient intraoperative temperature (⁰F) and relative humidity (RH) were recorded in 15-min intervals. The primary endpoint was superficial SSI, which was evaluated with multi-level logistic regression.
Results:
14,519 operations were analyzed with 179 SSIs (1.2%). The lower/upper 10th percentiles for temperature and RH were 64.4/71.4 °F and 33.5/55.5% respectively. Low or high temperature carried no significant increased risk for SSI (Low ⁰F OR = 0.95, 95% CI 0.51-1.77, P = 0.86; High ⁰F OR = 1.13, 95% CI = 0.69-1.86, P = 0.63). This was also true for low and high RH (Low RH OR = 0.96, 95% CI 0.58-1.61, p = 0.88; High RH OR = 0.61, 95% CI = 0.33-1.14, P = 0.12). Analysis of combined temperature/humidity showed no increased risk for SSI.
Conclusion:
Significant deviations in intraoperative temperature/humidity are not associated with increased risk of SSI.
Insights
Intraoperative temperature and humidity levels do not significantly impact surgical site infection (SSI) risk. This study found no increased risk of SSI from significant deviations in ambient operating room conditions.
Area of Science:
- Surgical Safety
- Infection Control
- Environmental Monitoring in Healthcare
Background:
- Limited research exists on the relationship between intraoperative environmental conditions and surgical site infections (SSIs).
- Understanding these factors is crucial for optimizing surgical outcomes and patient safety.
Purpose of the Study:
- To investigate the association between intraoperative ambient temperature and relative humidity and the risk of developing superficial surgical site infections (SSIs).
Main Methods:
- A retrospective review of 14,519 operations from three centers (2016-2020) reported to the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP).
- Intraoperative ambient temperature (°F) and relative humidity (RH) were recorded at 15-minute intervals.
- Multi-level logistic regression analysis was used to evaluate the primary endpoint: superficial SSI.
Main Results:
- No significant increase in SSI risk was observed with low or high intraoperative temperatures (ORs ranging from 0.95 to 1.13).
- Similarly, low or high relative humidity did not significantly elevate SSI risk (ORs ranging from 0.61 to 0.96).
- Combined analysis of temperature and humidity also showed no increased risk for SSI.
Conclusions:
- Significant deviations from typical intraoperative temperature and humidity ranges are not associated with an increased risk of surgical site infections.
- Current intraoperative environmental parameters may not be a critical modifiable factor for preventing superficial SSIs.
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