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Updated: Oct 21, 2026
Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management
Published on: November 21, 2017
The Effect of Post-Operative Localised Tissue Warming on Surgical Outcomes: A Systematic Review
Thiviya Sivakanthan1, Kwaku Duah-Asante2, Ife Oledajo3
1Department of Surgery, Imperial College Healthcare NHS Trust, London, UK.
Background:
Post-operative wound complications remain a significant source of morbidity following surgery, yet evidence-based strategies targeting the local wound environment in the post-operative period remain scarce. Local surgical site warming may represent a simple, low-cost intervention to improve outcomes by enhancing tissue perfusion, oxygenation, and immune function. This cross-specialty systematic review evaluated the safety and efficacy of post-operative local surgical site warming.
Methods:
A PRISMA-compliant systematic review was prospectively registered on PROSPERO. PubMed, Embase, and the Cochrane Library were searched from inception to April 2026. Studies investigating clinical outcomes following the application of heat directly to the surgical site post-operatively were included.
Results:
The primary literature search returned 20 076 articles. Following de-duplication and title/abstract and full-text screening, thirteen studies, with a total of 981 patients, were included. In plastic surgery, post-operative local warming increased microcirculatory blood flow by up to 103%, improved tissue oxygen saturation and local innate immunity, and was associated with superior free flap survival rates. Across general surgery and gynaecology, warming significantly improved wound healing parameters and subcutaneous oxygen tension, whilst also reducing post-operative pain and analgesic consumption. No thermal injuries or serious adverse effects were reported in any study.
Conclusions:
Post-operative local surgical site warming is safe and consistently improves tissue perfusion, oxygenation, and early wound healing, with compelling findings in soft tissue reconstruction. This review provides a foundation for prospective trials evaluating warming as an adjunct to standard post-operative wound care.
