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Perioperative, local and systemic warming in surgical site infection: A systematic review and meta-analysis


Ousey, K and Edward, KL and Lui, S and Stephenson, J and Walker, K and Duff, J and Leaper, D, Perioperative, local and systemic warming in surgical site infection: A systematic review and meta-analysis, Journal of Wound Care, 26, (11) pp. 614-624. ISSN 0969-0700 (2017) [Refereed Article]

Copyright Statement

Copyright 2017 MA Healthcare Ltd.

DOI: doi:10.12968/jowc.2017.26.11.614


Objective: Surgical site infection (SSI) is a common cause of postoperative morbidity. Perioperative hypothermia may contribute to surgical complications including increased risk of SSI. In this systematic review and meta-analysis, the effectiveness of active and passive perioperative warming interventions to prevent SSI was compared with standard (non-warming) care.

Method: Ovid MEDLINE; Ovid EMBASE; EBSCO CINAHL Plus; The Cochrane Wounds Specialised Register, and The Cochrane Central Register of Controlled Trials were searched, with no restrictions on language, publication date or study setting for randomised controlled trials (RCTs) and cluster RCTs. Adult patients undergoing elective or emergency surgery under general anaesthesia, receiving any active or passive warming intervention perioperatively were included. Selection, risk of bias assessment and data extraction were performed by two review authors, independently. Outcomes studied were SSI (primary outcome), inpatient mortality, hospital length of stay and pain (secondary outcomes).

Results: We identified four studies, including 769 patients. The risk ratio (RR) for SSI in warming groups was 0.36 [95% confidence interval (CI): 0.23, 0.56; p<0. 001]. Length of hospitalisation was 1.13 days less in warming groups [95% CI: −3.07, 5.33; p=0.600]. The RR for mortality in the warming groups was 0.77 [95% CI: 0.17, 3.43; p=0.730]. A meta-analysis for pain outcome could not be conducted.

Conclusion: This review provides evidence in favour of active warming to prevent SSI, but insufficient evidence of active warming to reduce length of hospital stay and mortality. Benefits of passive warming remain unclear and warrant further research.

Item Details

Item Type:Refereed Article
Keywords:meta-analysis, perioperative, surgical site infection, systematic review, warming
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Surgery
Objective Division:Health
Objective Group:Clinical health
Objective Field:Treatment of human diseases and conditions
UTAS Author:Walker, K (Professor Kim Walker)
UTAS Author:Duff, J (Dr Jed Duff)
ID Code:124379
Year Published:2017
Web of Science® Times Cited:9
Deposited By:Health Sciences
Deposited On:2018-02-20
Last Modified:2018-09-13

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