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Archive Infection Control 2018

Patient Warming Stops SSIs Cold

Maintaining normothermia promotes wound healing and helps reduce infection risks.

E. Dellinger

E. Dellinger, MD


Skin Prep
TO THE LETTER Make sure endoscope reprocessing guidelines are always followed and document that your scopes are clean and in good working order.

Warm patients are happy patients, but the benefits of maintaining normothermia extend well beyond the "ahh" factor. Warming surface skin areas increases blood flow and oxygen levels at the subcutaneous space, which is where superficial surgical site infections commonly occur. Increasing the blood supply to incisions also leads to better wound healing. Here's why controlling a patient's core body temperature through active warming should be part of your efforts to ensure patients leave your facility with nothing more than a healthy, healing scar.

1. Hypothermia helps bacteria

Bacteria that enter surgical incisions are attacked by white blood cells and antibodies. Quality laboratory-based data show white blood cells kill bacteria much more effectively when higher concentrations of oxygen are present within the white cells. Studies have also correlated low amounts of oxygen in tissue next to incisions with increased risk of surgical site infection. In other words, incisions with higher oxygen concentrations have better resistance to harmful bacteria.

Patient warming comes into play because the higher the body's core temperature, the higher the level of oxygen concentration in the surgical wound and surrounding tissues. Why? Vasoconstriction occurs in hypothermic patients to limit the amount of blood and oxygen that reaches the incision.

The link between normothermia and lower surgical infection risk has not been definitively proven, but there's plenty of evidence that suggests actively warmed patients are less likely to develop post-op infections. For example, research has shown that employing total body warming to maintain normothermia (36°C) in patients who underwent colorectal surgery reduced SSI risk by 67% compared with patients whose core body temperatures dipped into the hypothermic range (

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