Impact of Inadvertent Perioperative Hypothermia on Surgical Wound Infection Rates After Abdominal Procedures.

Abstract

Introduction

Postoperative wound infections, commonly referred to as surgical site infections (SSIs), are a primary driver of patient morbidity and represent a substantial financial burden on the healthcare system. While the etiology of SSIs is multifactorial, intraoperative hypothermia—characterized by a core body temperature below 36∘C—has been consistently identified as a significant and preventable contributor. This literature review synthesizes evidence on the association between intraoperative hypothermia and the occurrence of SSIs among patients undergoing general abdominal surgery. A thorough understanding of this connection is vital for enhancing patient safety and improving postoperative recovery.

Literature Review

A robust body of literature indicates a direct link between a drop in core body temperature during surgery and an elevated risk of SSIs. The primary physiological mechanisms responsible for this association involve both compromised host defense mechanisms, such as diminished neutrophil function and reduced oxidative killing, and peripheral vasoconstriction, which impairs oxygen delivery to surgical tissues. Research demonstrates that even minor decreases in temperature can substantially increase SSI frequency by weakening the body's natural ability to combat bacterial contamination at the incision site. Proactive interventions, notably convective warming systems (forced-air warmers) and the administration of heated intravenous fluids, have proven effective in preserving normothermia and, as a result, lowering SSI rates. The detrimental impact of hypothermia is often particularly pronounced during extensive or lengthy abdominal surgeries.

Conclusion

Intraoperative hypothermia stands out as a key modifiable risk factor that substantially elevates the incidence of surgical site infections following general abdominal surgery. Consequently, the preservation of normothermia throughout the perioperative phase is an indispensable element of comprehensive infection control strategies. The routine adoption of active thermal management techniques should be considered a standard of care to bolster patient safety and alleviate the clinical and economic impact of SSIs. Future investigations should aim to define optimal warming protocols and identify patient-specific variables to further refine these crucial preventative efforts.