The Influence of Intraoperative Hypothermia on Surgical Site Infection Rates in General Abdominal Surgery

Abstract

Introduction: Surgical site infections (SSIs) represent a significant source of morbidity and healthcare costs following surgical procedures. While numerous factors contribute to SSI risk, intraoperative hypothermia, defined as a core body temperature below 36∘C, has been consistently implicated as a preventable risk factor. This literature review examines the relationship between intraoperative hypothermia and the incidence of surgical site infections in patients undergoing general abdominal surgery, a common domain in general surgery. Understanding this connection is crucial for optimizing patient care and improving postoperative outcomes.

Literature Review: The available evidence strongly suggests a direct correlation between intraoperative hypothermia and an increased risk of SSIs. Mechanisms proposed for this association include impaired immune function, leading to reduced neutrophil activity and oxidative killing capacity, and vasoconstriction, which decreases oxygen delivery to surgical tissues. Studies have demonstrated that even mild hypothermia can significantly elevate SSI rates by compromising the host's ability to resist bacterial contamination. Various interventions, such as forced-air warming devices and warmed intravenous fluids, have been shown to maintain normothermia and consequently reduce SSI incidence. The impact of hypothermia appears to be particularly relevant in prolonged or complex abdominal procedures.

Conclusion: Intraoperative hypothermia is a modifiable risk factor that significantly contributes to the incidence of surgical site infections in general abdominal surgery. Maintaining normothermia throughout the perioperative period is a critical component of infection prevention strategies. Implementing active warming measures should be a standard practice to improve patient safety and reduce the burden of SSIs. Further research focusing on optimal warming protocols and patient-specific risk factors could further refine these strategies.