The OR is cold (typically 60-66 degrees) and that leaves most us standing around cold and miserable. We get it. Stressed surgeons operating under bright lights, wrapped in sterile surgical gowns, prefer cooler temperatures. But the rest of us can only stand, shiver, and try to think of something else. Wearing an OPERATIONHEATJAC helps OR staff stay warm.
Life-threatening Surgical Site Infections (SSIs) strike 12-thousand patients every year.
Now it appears SSIs are linked to our cold ORs. 2011 study suggests the Bair Hugger may raise the risk of SSIs. The controversy has resulted in over 3000 lawsuits so far against the Bair Hugger’s maker, 3M.
But why would a forced air blanket cause SSIs? Plaintiff’s lawyers argue because the forced air device swirls germs from the floor over the surgical site as a result of waste heat interfering with laminar flow. However, several simulations don’t back this up, and the FDA has taken the stance that the Bair Hugger is safe and does not need to be taken off of the market. Moreover, the authors of this study explicitly disclaim any ability to attribute changes in infection rates to forced-air warming, stating “[t]his study does not establish a causal link for the association.” In addition, the study has many flaws. One such flaw is that the study did not control for important confounding variables that influence SSIs. In fact, there was a change in prophylactic antibiotic administration to the patients during the two study periods, and this is known to be a most important factor for preventing these SSIs.
A well-designed study was published in the Journal of Clinical Anesthesia in February 2017, entitled: Airborne bacterial contamination during orthopedic surgery: A randomized controlled pilot trial. This study measured bacterial counts in six locations in the operating room, with a group of 80 different patients. The study found that “it was not possible to detect any higher bacterial counts on any plate in the forced-air warming group (the Bair Hugger system) versus the resistive warming [non-forced air warming] group (the HotDog blanket).”
Where are these infections coming from if the FDA takes the position that the Bair Hugger forced-air warming system is safe?
As a practicing anesthesiologist for over 25 years I believe the real cause is a common, if poorly hidden, operating room ritual: cold and uncomfortable OR staff put the Bair Hugger hose under their scrubs. I hear about this all the time, particularly at society and association meetings. This practice in my opinion can blow squamous skin cells covered in bacteria throughout the OR and is most likely the cause of the SSis. Some hospitals, now concerned about liability, have recently banned this practice.
I believe that by providing OR staff with another warming source, OPERATIONHEATJAC doesn’t just benefit my colleagues, it benefits our patients as well.
For further reading see
Lawsuits turn up heat on 3M’s Bair Hugger warming blankets
Minneapolis Star Tribune 10/27/2017
Effects of Forced Air Warming on Airflow around the Operating Table
(Simulation suggests forced air systems do not cause surgical contamination)