Abstract
Methods: Ovid MEDLINE; Ovid EMBASE; EBSCO CINAHL Plus; The Cochrane Wounds Specialised Register; 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; including adult patients undergoing elective or emergency surgery under general anaesthesia, receiving any active or passive warming intervention perioperatively. Two review authors independently performed study selection, risk of bias assessment and data extraction. Outcomes studied were SSI (primary outcome), inpatient mortality, hospital length of stay and pain (secondary outcomes).
Results: Four studies, including 768 patients, were identified. The risk ratio 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 risk ratio 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.
Interpretations: 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.
| Language | English |
|---|---|
| Pages | 614-624 |
| Number of pages | 11 |
| Journal | Journal of wound care |
| Volume | 26 |
| Issue number | 11 |
| Early online date | 13 Nov 2017 |
| DOIs | |
| Publication status | Published - Nov 2017 |
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Perioperative, Local and Systemic Warming to Prevent Surgical Site Infection : A Systematic Review and Meta-Analysis. / Ousey, Karen; Edward, Karen Leigh; Lui, Sun; Stephenson, John; Walker, Kim; Duff, Jed; Leaper, David.
In: Journal of wound care, Vol. 26, No. 11, 11.2017, p. 614-624.Research output: Contribution to journal › Article
TY - JOUR
T1 - Perioperative, Local and Systemic Warming to Prevent Surgical Site Infection
T2 - Journal of wound care
AU - Ousey, Karen
AU - Edward, Karen Leigh
AU - Lui, Sun
AU - Stephenson, John
AU - Walker, Kim
AU - Duff, Jed
AU - Leaper, David
PY - 2017/11
Y1 - 2017/11
N2 - 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.Methods: Ovid MEDLINE; Ovid EMBASE; EBSCO CINAHL Plus; The Cochrane Wounds Specialised Register; 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; including adult patients undergoing elective or emergency surgery under general anaesthesia, receiving any active or passive warming intervention perioperatively. Two review authors independently performed study selection, risk of bias assessment and data extraction. Outcomes studied were SSI (primary outcome), inpatient mortality, hospital length of stay and pain (secondary outcomes).Results: Four studies, including 768 patients, were identified. The risk ratio 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 risk ratio 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.Interpretations: 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.
AB - 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.Methods: Ovid MEDLINE; Ovid EMBASE; EBSCO CINAHL Plus; The Cochrane Wounds Specialised Register; 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; including adult patients undergoing elective or emergency surgery under general anaesthesia, receiving any active or passive warming intervention perioperatively. Two review authors independently performed study selection, risk of bias assessment and data extraction. Outcomes studied were SSI (primary outcome), inpatient mortality, hospital length of stay and pain (secondary outcomes).Results: Four studies, including 768 patients, were identified. The risk ratio 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 risk ratio 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.Interpretations: 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.
KW - Surgical site infection
KW - Perioperative
KW - Warming
KW - Systematic review
KW - Meta analysis
UR - http://www.magonlinelibrary.com/toc/jowc/current
U2 - 10.12968/jowc.2017.26.11.614
DO - 10.12968/jowc.2017.26.11.614
M3 - Article
VL - 26
SP - 614
EP - 624
JO - Journal of wound care
JF - Journal of wound care
SN - 0969-0700
IS - 11
ER -