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Process for maintaining normothermia in surgical patients

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  • #70462
    Michael Wishart
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    Michael Wishart

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    [Posted on behalf of Fiona De Sousa – Moderator]

    Hi All,

    We are currently reviewing the methods our facility uses to maintain normothermia in surgical patients. A number of recent publications have suggested that forced air warming for joint replacement patients may contribute to deep surgical site infections.

    What methods are facilities using to maintain normothermia in this patient group?
    Kind regards,

    Fiona De Sousa
    Infection Prevention & Control Coordinator
    Sydney Adventist Hospital
    Fiona.Desousa@sah.org.au
    185 Fox Valley Road, Wahroonga, NSW, 2076


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    #70466
    Michael Wishart
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    Michael Wishart

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    Hi Fiona

    Interesting issue. I do not think we actually use forced air warming during major orthopaedic cases, but have asked the question of our orthopaedic nursing staff.

    We did have concerns from surgeons about another air powered device we use to transfer patients whose weight is greater than 100kgs onto the operating table. This device requires that a mat is left under the patient for the duration of the procedure, so that is can be inflated to allow the patient to be transferred off the operating table after the procedure. The concern of surgeons was that the instrument tables were already prepared as the patient was transferred using this device, and that contamination of the instrument sets and potentially prosthetic items could occur due to disrupted air flow. We did do a small study using a slit sampler at instrument table height to see what particle and microbial counts were like during the use of this device, and there was no discernible difference between counts when using the device and manual transfer without the device. It was quite a small study, so we did not look at publishing results, but along with other studies provided by the device manufacturer the surgeons accepted that using this device did not increase risk of PJI.

    As part of searching for information about this issue I came across this review by a research group. This includes mention of a current court case in the US concerning this very issue. Not sure what the outcome was of this.

    https://www.ecri.org/Documents/Reprints/Forced-Air_Warming_and_Surgical_Site_Infections(Health_Devices).pdf

    Cheers
    Michael

    Michael Wishart
    CNC Infection Control
    Holy Spirit Northside Private Hospital
    627 Rode Road, Chermside, Qld 4032
    t: (07) 3326 3068 | f: (07) 3607 2226
    e: Michael.Wishart@hsn.org.au
    w:www.holyspiritnorthside.org.au
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    [Posted on behalf of Fiona De Sousa – Moderator]

    Hi All,

    We are currently reviewing the methods our facility uses to maintain normothermia in surgical patients. A number of recent publications have suggested that forced air warming for joint replacement patients may contribute to deep surgical site infections.

    What methods are facilities using to maintain normothermia in this patient group?
    Kind regards,

    Fiona De Sousa
    Infection Prevention & Control Coordinator
    Sydney Adventist Hospital
    Fiona.Desousa@sah.org.au
    185 Fox Valley Road, Wahroonga, NSW, 2076

    WARNING : This email contains information, which is CONFIDENTIAL, and that maybe subject to LEGAL PRIVILEGE. This e-mail and any attachments to it (the “Communication”) is confidential and is for the use only of the intended recipient, and may not duplicated or used by any other party without the express consent of the sender. The Communication may contain copyright material of St Vincent’s Health & Aged Care(“SVHAC”), or any of its related entities or of third parties. If you are not the intended recipient of the Communication, please notify the sender immediately by return e-mail, delete the Communication, and do not read, copy, print, retransmit, store or act in reliance on the Communication. Any views expressed in the Communication are those of the individual sender only, unless expressly stated to be those of SVHAC. SVHAC does not guarantee the integrity of the Communication, or that it is free from errors, viruses or interference. Thank-you.
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