Kellam Melissa D, Dieckmann Loraine S, Austin Paul N
AORN J. 2013 Oct;98(4):354-66; quiz 367-9. doi: 10.1016/j.aorn.2013.08.001.
The potential that forced-air warming systems may increase the risk of surgical site infections (SSIs) by acting as a vector or causing unwanted airflow disturbances is a concern to health care providers. To investigate this potential, we examined the literature to determine whether forced-air warming devices increase the risk of SSIs in patients undergoing general, vascular, or orthopedic surgical procedures. We examined 192 evidence sources, 15 of which met our inclusion criteria. Most sources we found indirectly addressed the issue of forced-air warming and only three studies followed patients who were warmed intraoperatively with forced-air warming devices to determine whether there was an increased incidence of SSIs. All of the sources we examined contained methodological concerns, and the evidence did not conclusively suggest that the use of forced-air warming systems increases the risk of SSIs. Given the efficacy of these devices in preventing inadvertent perioperative hypothermia, practitioners should continue to use and clean forced-air warming systems according to the manufacturer's instructions until well-conducted, large-scale trials can further examine the issue.
医护人员担心，强制空气加热系统可能作为一种媒介或导致不必要的气流干扰，从而增加手术部位感染（SSI）的风险。为了研究这种可能性，我们查阅了文献，以确定强制空气加热设备是否会增加接受普通外科、血管外科或骨科手术的患者发生SSI的风险。我们查阅了192个证据来源，其中15个符合我们的纳入标准。我们发现大多数来源只是间接涉及强制空气加热问题，只有三项研究跟踪了术中使用强制空气加热设备进行保暖的患者，以确定SSI的发生率是否增加。我们查阅的所有来源都存在方法学问题，而且证据并未确凿表明使用强制空气加热系统会增加SSI的风险。鉴于这些设备在预防围手术期意外体温过低方面的有效性，在有良好设计的大规模试验能够进一步研究这个问题之前，从业者应继续按照制造商的说明使用和清洁强制空气加热系统。
