Forced-air warming devices and the risk of surgical site infections

The potential that forced-air warming systems may increase the risk of surgical site infections (SSIs) by acting as a vector or causing unwanted airflow disturbances is a concern to health care providers. To investigate this potential, we examined the literature to determine whether forced-air warming devices increase the risk of SSIs in patients undergoing general, vascular, or orthopedic surgical procedures. We examined 192 evidence sources, 15 of which met our inclusion criteria. Most sources we found indirectly addressed the issue of forced-air warming and only three studies followed patients who were warmed intraoperatively with forced-air warming devices to determine whether there was an increased incidence of SSIs. All of the sources we examined contained methodological concerns, and the evidence did not conclusively suggest that the use of forced-air warming systems increases the risk of SSIs. Given the efficacy of these devices in preventing inadvertent perioperative hypothermia, practitioners should continue to use and clean forced-air warming systems according to the manufacturer's instructions until well-conducted, large-scale trials can further examine the issue.