BACKGROUND: Perioperative hypothermia can lead to surgical complications, including bleeding, infection, increased patient discomfort, and longer recovery time. Plastic surgeons have become increasingly aware of this important patient safety issue. OBJECTIVES: The authors evaluate the impact of perioperative warming in an outpatient plastic surgery setting. METHODS: A retrospective review was performed of 108 patients who received several simple measures to prevent perioperative hypothermia. Patients dressed in warm clothing and were covered with an electric blanket in both the holding area and the recovery room. Intraoperative interventions included higher ambient room temperature, skin exposure only at the surgical site, forced-air warming, and the use of warmed fluids. This warmed group was compared with a historical control group of 106 patients who underwent plastic surgery in the period immediately before implementation of these measures. Patient demographics and procedural characteristics were similar for the 2 groups. RESULTS: The requirement for intraoperative analgesia was significantly lower for the warmed group (111 vs 125 µg fentanyl in the control group; P = .042). Patients in the warmed group required less time in the recovery room and met discharge criteria sooner (127 vs 141 minutes; P = .001). No significant difference was observed in the incidence of complications. CONCLUSIONS: Simple measures to maintain perioperative normothermia improve patient comfort and recovery following aesthetic surgery. Through a continuous-improvement culture, the authors have successfully implemented warming strategies that prevent perioperative hypothermia and improve surgical outcomes.
BACKGROUND: Perioperative hypothermia can lead to surgical complications, including bleeding, infection, increased patient discomfort, and longer recovery time. Plastic surgeons have become increasingly aware of this important patient safety issue. OBJECTIVES: The authors evaluate the impact of perioperative warming in an outpatient plastic surgery setting. METHODS: A retrospective review was performed of 108 patients who received several simple measures to prevent perioperative hypothermia. Patients dressed in warm clothing and were covered with an electric blanket in both the holding area and the recovery room. Intraoperative interventions included higher ambient room temperature, skin exposure only at the surgical site, forced-air warming, and the use of warmed fluids. This warmed group was compared with a historical control group of 106 patients who underwent plastic surgery in the period immediately before implementation of these measures. Patient demographics and procedural characteristics were similar for the 2 groups. RESULTS: The requirement for intraoperative analgesia was significantly lower for the warmed group (111 vs 125 µg fentanyl in the control group; P = .042). Patients in the warmed group required less time in the recovery room and met discharge criteria sooner (127 vs 141 minutes; P = .001). No significant difference was observed in the incidence of complications. CONCLUSIONS: Simple measures to maintain perioperative normothermia improve patient comfort and recovery following aesthetic surgery. Through a continuous-improvement culture, the authors have successfully implemented warming strategies that prevent perioperative hypothermia and improve surgical outcomes.
Authors: Jamil Ahmad; Olivia A Ho; Wayne W Carman; Achilles Thoma; Donald H Lalonde; Frank Lista Journal: Plast Surg (Oakv) Date: 2014 Impact factor: 0.947