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Archives of Orthopaedic and Trauma Surgery

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27-07-2023 | Antibiotic | Hip Arthroplasty

Analysis of the effects of intraoperative warming devices on surgical site infection in elective hip arthroplasty using a large nationwide database

Authors: Seung Hoon Kim, Suk-Yong Jang, Yonghan Cha, Bo-Yeon Kim, Hyo-Jung Lee, Gui-Ok Kim

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 12/2023

Abstract

Introduction

The aim of our study is to analyze the association of usage and type of warming device with the risk of surgical site infection (SSI) in patients who underwent hip arthroplasty, and to analyze the factors that increase the risk of SSI if the warming device is not used.

Materials and methods

This retrospective cross-sectional study identified subjects from data of “Evaluation of the Appropriate Use of Prophylactic Antibiotics”. Included patients were defined as those who underwent elective unilateral hip hemiarthroplasty or total hip arthroplasty (THA). Patients were classified into no intraoperative warming device, forced air warming devices, and devices using conduction. Multiple logistic regression analysis was conducted to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) to assess the association between warming devices and SSI.

Results

A total of 3945 patients met the inclusion criteria. Compared to those who received an intraoperative warming device, the odds of developing SSI were 1.9 times higher in those who did not receive intraoperative warming devices (aOR 1.9; 95% CI 1.1–3.6). The risk of SSI was 2.2 times higher with forced air warming devices compared to devices using conduction but this difference was not statistically significant (aOR 2.2; 95% CI 0.7–6.8). The risk of SSI increased in males (aOR 2.8; 95% CI 1.1–7.2), in patients under 70 years of age (aOR 4.4; 95% CI 1.6–10.4), in patients with a Charlson`s comorbidity index of 2 or higher (aOR 3.3; 95% CI 1.3–8.7), and in patients who underwent THA (aOR 3.8; 95% CI 1.7–8.3) when intraoperative warming devices were not used.

Conclusions

The use of intraoperative active warming devices is highly recommended to prevent SSI during elective hip arthroplasty. In particular, male patients younger than 70 years, those with a high CCI, and those undergoing THA are at significantly increased risk of SSI if intraoperative active warming devices are not used. Intraoperative warming device using conduction is likely superior to forced air warming device, but further studies are needed to confirm this.

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Title: Analysis of the effects of intraoperative warming devices on surgical site infection in elective hip arthroplasty using a large nationwide database
Authors: Seung Hoon Kim
Suk-Yong Jang
Yonghan Cha
Bo-Yeon Kim
Hyo-Jung Lee
Gui-Ok Kim
Publication date: 27-07-2023
Publisher: Springer Berlin Heidelberg
Keywords: Antibiotic
Hip-TEP
Hip-TEP
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 12/2023
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-023-04917-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Analysis of the effects of intraoperative warming devices on surgical site infection in elective hip arthroplasty using a large nationwide database

Abstract

Introduction

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

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