Constantine Ryan S, Kenkel Matthew, Hein Rachel E, Cortez Roberto, Anigian Kendall, Davis Kathryn E, Kenkel Jeffrey M
From the Department of Plastic and Reconstructive Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
Aesthet Surg J. 2015 Jan;35(1):81-8. doi: 10.1093/asj/sju022.
Perioperative hypothermia has been associated with increased rates of infection, prolonged recovery time, and coagulopathy.
The authors assessed the impact of hypothermia on patient outcomes after plastic surgery and analyzed the impact of prewarming on postoperative outcomes.
The medical charts of 1062 patients who underwent complex plastic surgery typically lasting at least 1 hour were reviewed. Hypothermia was defined as a temperature at or below 36°C. Postoperative complication data were collected for outcomes including infection, delayed wound healing, seroma, hematoma, dehiscence, deep venous thrombosis, and overall wound problems. Odds ratios (ORs) were estimated from 3 multivariate logistic regression models of hypothermia and one model of body contouring procedures that included prewarming as a parameter.
Perioperative hypothermia was not a significant predictor of wound problems (OR = 0.83; P = .28). In the stratified regression model, hypothermia did not significantly impact wound problems. The regression model measuring the interaction between hypothermia and operating time did not show a significantly increased risk of wound problems. Prewarming did not significantly affect perioperative hypothermia (P = .510), and in the model of body contouring procedures with prewarming as a categorical variable, massive weight loss was the most significant predictor of wound complications (OR = 2.57; P = .003). Prewarming did not significantly affect outcomes (OR = 1.49; P = .212).
Based on univariate and multivariate models in our study, mild perioperative hypothermia appears to be independent of wound complications. LEVEL OF EVIDENCE 4: Risk.
围手术期体温过低与感染率增加、恢复时间延长及凝血病有关。
作者评估了体温过低对整形手术后患者预后的影响，并分析了预保温对术后预后的影响。
回顾了1062例行复杂整形手术（通常持续至少1小时）患者的病历。体温过低定义为体温等于或低于36°C。收集术后并发症数据，观察指标包括感染、伤口愈合延迟、血清肿、血肿、裂开、深静脉血栓形成及总体伤口问题。通过3个体温过低的多变量逻辑回归模型和1个将预保温作为参数的身体塑形手术模型估计比值比（OR）。
围手术期体温过低不是伤口问题的显著预测因素（OR = 0.83；P = 0.28）。在分层回归模型中，体温过低对伤口问题没有显著影响。测量体温过低与手术时间之间相互作用的回归模型未显示伤口问题风险显著增加。预保温对围手术期体温过低没有显著影响（P = 0.510），在以预保温作为分类变量的身体塑形手术模型中，大量体重减轻是伤口并发症的最显著预测因素（OR = 2.57；P = 0.003）。预保温对预后没有显著影响（OR = 1.49；P = 0.212）。
基于我们研究中的单变量和多变量模型，轻度围手术期体温过低似乎与伤口并发症无关。证据等级4：风险。
