A systematic review of surgical site infection and wound complications in patients who received forced-air warm device during surgical procedures

Aim: The objective of this systematic review was to identify and synthesize available evidence on the impact of forced-air warming (FAW) on surgical site infection (SSI) and wound complications.
Method: We searched CINAHL, EMBASE, Medline and CENTRAL. The primary analysis included various eligible study types (e.g., RCTs, non-randomized trials, cohort studies) comparing Forced Air Warming (FAW) devices to other warming methods in adult patients (18 years and above) undergoing elective or emergency surgery. The focus was on outcomes related to surgical site infection, surgical wound contamination, and other complications like wound dehiscence and seromas.
Results / Discussion: Fourteen primary studies were included in this review, comprising nine RCTs, one non-RCTs and four observational studies published in English from 1996 to 2022. We conducted a meta-analysis of SSI rates in nine RCTs, and subgroup analyses of 30-day SSI and 90-day SSI rates. Our pooled analysis indicated that FAW is more effective in prevent hypothermia than non-FAW warming, a reduction of 53% in the odds of having post-surgery hypothermia compared to those patients without using FAW (Odds ratio=0.47, 95% CI 0.35-0.65, p<0.0001, I2 = 58%). There was insufficient evidence to definitely proof that using FAW devices leads to rise in SSIs among patients who had undergone surgical procedures.
Conclusion: Future larger sample size of multicentre well designed RCTs should focus on individual types of surgical specialties, with well documented patients’ characteristic data and anaesthetic method needed to support current practice in heterogeneous populations.