Department of Molecular Medicine, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
Wound Repair Regen. 2010 Jul-Aug;18(4):378-82. doi: 10.1111/j.1524-475X.2010.00602.x.
In open surgery, heat is lost due to radiation and evaporation through the wound. Hypothermia causes tissue hypoxia and impairs various cellular immune functions that increases the risk for postoperative wound infections and delayed wound healing. The patient's body is usually well protected with heating arrangements, but the open wound is left unprotected and until now no practical method has been available to protect it thermically. We therefore investigated if insufflation of an open surgical wound with carbon dioxide would affect wound temperature. In 10 patients undergoing cardiac surgery, the sternotomy wound was insufflated with dry, room temperature carbon dioxide via a gas diffuser for 2 minutes. A heat-sensitive camera measured the wound temperature before, during, and after insufflation. Exposure to carbon dioxide increased the median temperature of the whole wound by 0.5 degrees C (p=0.01). The temperature of the area distant to the diffuser increased by 1.2 degrees C (p<0.01) whereas in the area close to the diffuser it decreased by 1.8 degrees C (p<0.01). In conclusion, short-term insufflation of dry room temperature carbon dioxide in an open wound increases the surface temperature significantly. Although a small increase, it may reduce the incidence of postoperative wound infections in the future.
在开放性手术中，热量会通过辐射和伤口蒸发而流失。体温过低会导致组织缺氧，并损害各种细胞免疫功能，增加术后伤口感染和愈合延迟的风险。患者的身体通常有很好的加热设备保护，但开放性伤口则没有得到保护，到目前为止，还没有实用的方法可以对其进行热保护。因此，我们研究了向开放性手术伤口内吹入二氧化碳是否会影响伤口温度。在 10 名接受心脏手术的患者中，通过气体扩散器将干燥、室温的二氧化碳吹入胸骨切开伤口持续 2 分钟。一个热敏摄像机在吹入前、吹入中和吹入后测量伤口温度。暴露于二氧化碳使整个伤口的中位数温度升高了 0.5 摄氏度（p=0.01）。离扩散器较远的区域温度升高了 1.2 摄氏度（p<0.01），而靠近扩散器的区域温度降低了 1.8 摄氏度（p<0.01）。总之，在开放性伤口中短期吹入干燥室温的二氧化碳会显著增加表面温度。尽管只是微小的增加，但将来可能会降低术后伤口感染的发生率。
