Intraoperative Hypothermia in Plastic Surgery: Procedure-Specific Patterns and the Call for Preventive Strategies.

Area of Science:

• Anesthesiology
• Plastic Surgery
• Perioperative Medicine

Background:

• Intraoperative hypothermia is a frequent complication in plastic surgery.
• It increases risks of surgical site infections, coagulopathy, and delayed recovery.
• Current warming strategies may be insufficient, necessitating a review of temperature dynamics.

Purpose of the Study:

• To characterize intraoperative temperature changes in plastic surgery.
• To identify specific procedures associated with increased risk of hypothermia.
• To inform and improve perioperative warming protocols.

Main Methods:

• Retrospective review of 1923 elective plastic and reconstructive surgeries under general anesthesia.
• Core temperatures monitored pre-incision and postoperatively.
• Multivariable regression analysis to identify predictors of temperature change and hypothermia.

Main Results:

• Mean intraoperative temperature change was +0.16°C, with significant procedure-specific variations.
• Hand surgery showed significant temperature decreases; body contouring and hand procedures increased hypothermia risk (OR 3.91, P=.004).
• Preincision hypothermia affected 36.6% and postoperative hypothermia 32.3% of patients.

Conclusions:

• Hypothermia is highly prevalent in plastic surgery, particularly for hand and body contouring.
• High rates of preincision hypothermia highlight the need for enhanced perioperative warming.
• Consistent multimodal warming strategies are essential to maintain normothermia and reduce complications.