Warming before surgery reduces postoperative wound infection

September 13, 2001

N.B. Please note that if you are outside North America, the embargo for Lancet press material is 0001 hours UK Time Friday 14th September 2001.

A randomised trial in this week's issue of THE LANCET shows how postoperative wound infection could be substantially reduced if patients are given localised or systemic warming before undergoing surgery.

Wound infection after clean surgery (uninfected, operative surgery, where no inflammation is encountered and the respiratory, alimentary, and genitourinary tracts are not opened) is an expensive and underestimated cause of patient illness. The benefits of using prophylactic antibiotics in this type of surgery have not been proven. Warming patients during colorectal surgery has previously been shown to reduce infection rates. Andrew Melling and colleagues from the University Hospital of North Tees, Stockton-on-Tees, UK, assessed whether warming patients before short duration, clean surgery would have the same effect.

421 patients having clean (breast, varicose vein, or hernia) surgery were randomly assigned to either a non-warmed (standard) group or one of two warmed groups (local and systemic). Warming was applied at least 30 minutes before surgery. Patients were followed up at two and six weeks after surgery.

The investigators identified 19 wound infections in 139 non-warmed patients (14%) compared with 13 in 277 who received warming (5%). Patients not given warming were prescribed substantially more postoperative antibiotics

Andrew Melling comments: "The surgical episode and the first few hours afterwards have been widely accepted as the key period when a wound infection is likely to become established. Our study suggests that the hour before surgery may be just as important. The simple addition of two different types of warming, applied for at least 30 minutes before surgery, have both clearly reduced infection rates and therefore the need for additional treatment, including postoperative antibiotics. Preoperative warming may be an alternative to the controversial use of prophylactic antibiotics, that avoids the associated risks of allergy and resistance, in clean surgery."
-end-
Contact: Mr Andrew C Melling, Professorial Unit of Surgery, North Tees & Hartlepool NHS Trust, University Hospital of North Tees, Hardwick, Stockton-On-Tees, TS19 8PE, UK; T) +44 (0)1642 624087 F) +44 (0)1642 624165; E) AndyMelling@Compuserve.com

Lancet

Related Surgery Articles from Brightsurf:

Decision conflict before cancer surgery correlates with lower activity after surgery
Nearly one-third of cancer patients who decide to undergo surgery for their condition may have second thoughts, and this decision conflict may lead to less favorable treatment outcomes in both the near- and long-term, according to a team of investigators at Massachusetts General Hospital and Ariadne Labs.

Examining association between weight loss before bariatric surgery, risk of death after surgery
Researchers looked at whether a patient's body weight and weight loss before bariatric surgery were associated with risk of death within 30 days after surgery using data from nearly 500,000 patients in the US and Canada.

Guidelines for thyroid surgery published in Annals of Surgery
The first set of comprehensive, evidence-based clinical guidelines for surgical treatment of thyroid disease -- developed by an expert panel assembled by the American Association of Endocrine Surgeons (AAES) -- was published today by Annals of Surgery.

Colorectal surgery patients use fewer opioids, report less pain with enhanced recovery after surgery
Colorectal surgery patients who were a part of an enhanced recovery after surgery (ERAS) program had less pain, while using nearly half as many opioids, according to research being presented at the ANESTHESIOLOGY® 2019 annual meeting.

Video assisted lung surgery reduces complications and hospital stays compared to open surgery
Video-assisted thoracic surgery is associated with lower in-hospital complications and shorter length of stay compared with open surgery among British patients who were diagnosed at an early stage of lung cancer, according to research presented today the IASLC 2019 World Conference on Lung Cancer, hosted by the International Association for the Study of Lung Cancer.

Most deaths related to noncardiac surgery occur after surgery and after discharge from hospital
It's not the operating room that is risky for patients undergoing noncardiac surgery; it's the recovery period.

Study looks at opioid use after knee surgery
A small study looked at whether reducing the number of opioid tablets prescribed after knee surgery would reduce postoperative use and if preoperative opioid-use education would reduce it even more.

Surgery patients are getting older every year
A new BJS (British Journal of Surgery) analysis reveals that people undergoing surgery in England are getting older at a faster rate than the general population.

Children requiring thyroid surgery have better outcomes at high-volume surgery centers
New research recently published in the Journal of Pediatric Surgery found that post-operative success rates of pediatric thyroid patients, particularly children who require a thyroidectomy, correlate with the institution's patient volume.

Do negative public attitudes toward weight loss surgery stop some patients from having surgery?
Most patients who qualify for weight loss surgery don't have the procedure despite its safety and effectiveness.

Read More: Surgery News and Surgery Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.