Topical Humidified Carbon Dioxide to Keep the Open Surgical Wound Warm (original) (raw)
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Effect of heated and humidified carbon dioxide gas on core temperature and postoperative pain
Surgical Endoscopy, 2002
Background: Intraoperative hypothermia is a common event during laparoscopic operations. An external warming blanket has been shown to be eective in preventing hypothermia. It has now been proposed that using heated and humidi®ed insuation gas can prevent hypothermia and decrease postoperative pain. Therefore, we examined the extent of intraoperative hypothermia in patients undergoing laparoscopic Nissen fundoplication using an upper body warming blanket. We also attempted to determine whether using heated and humidi®ed insuation gas in addition to an external warming blanket would help to maintain intraoperative core temperature or decrease postoperative pain. Methods: Twenty patients were randomized to receive either standard carbon dioxide (CO 2) gas (control, n = 10) or heated and humidi®ed gas (heated and hu-midi®ed, n = 10). After the induction of anesthesia, an external warming blanket was placed on all patients in both groups. Intraoperative core temperature and intraabdominal temperature were measured at 15-min intervals. Postoperative pain intensity was assessed using a visual analogue pain scale, and the amount of analgesic consumption was recorded. Volume of gas delivered, number of lens-fogging episodes, intraoperative urine output, and hemodynamic data were also recorded. Results: There was no signi®cant dierence between the two groups in age, length of operation, or volume of CO 2 gas delivered. Compared with baseline value, mean core temperature increased by 0.4°C in the heated and humidi®ed group and by 0.3°C in the control group at 1.5 h after surgical incision. Intraabdominal temperature increased by 0.2°C in the heated and humidi®ed group but decreased by 0.5°C in the control group at 1.5 h after abdominal insuation. There was no signi®cant dierence between the two groups in visual analog pain scale (5.4 1.6 control vs 4.5 2.8 heated and hu-midi®ed), morphine consumed (27 26 mg control vs 32 19 mg heated and humidi®ed), urine output, lensfogging episodes, or hemodynamic parameters. Conclusion: Heated and humidi®ed gas, when used in addition to an external warming blanket, minimized the reduction of intraabdominal temperature but did not alter core temperature or reduce postoperative pain.
Geburtshilfe und Frauenheilkunde
Introduction Hypothermia is defined as a decrease in body core temperature to below 36 °C. If intraoperative heat-preserving measures are omitted, a patientʼs temperature will fall by 1 – 2 °C. Even mild forms of intraoperative hypothermia can lead to a marked increase in morbidity and mortality. The temperature of the insufflation gas is usually disregarded in the treatment and prevention of hypothermia. This study was conducted to investigate the effect of body-temperature and humidified CO2 on the intraoperative temperature profile and avoidance of hypothermia in laparoscopic surgery. Material and Methods In this retrospective, non-randomised case control study, 110 patients whose planned operation lasted at least 60 minutes were identified from 376 patients by means of an algorithm. Dry (20% humidity) CO2 at room temperature was insufflated in 51 patients (control group). 59 patients were insufflated with humidified (98% humidity) CO2 at body temperature (37 °C) (study group). T...
2016
Cancer CRP C-reactive Protein CSV Comma-separated Values xix Thermography Imaging the temperatures in a material, or in the body or an organ. Imaging is based on self-emanating infrared radiation (heat waves), or on changes in properties of the material or tissue that vary with temperature, such as elasticity; magnetic field; or luminescence [MeSH term] Wound healing Restoration of integrity to traumatized tissue [MeSH term] xx PUBLICATIONS AND PRESENTATIONS Publications Journal of Wound Care (JWC)-submitted and published Siah, C. J., & Childs, C. (2015). Thermographic mapping of the abdomen in healthy subjects and patients after enterostoma.
Journal of Wound Care, 2017
Objective: Surgical site infection (SSI) is a common cause of postoperative morbidity. Perioperative hypothermia may contribute to surgical complications including increased risk of SSI. In this systematic review and meta-analysis, the effectiveness of active and passive perioperative warming interventions to prevent SSI was compared with standard (non-warming) care. Method: Ovid MEDLINE; Ovid EMBASE; EBSCO CINAHL Plus; The Cochrane Wounds Specialised Register, and The Cochrane Central Register of Controlled Trials were searched, with no restrictions on language, publication date or study setting for randomised controlled trials (RCTs) and cluster RCTs. Adult patients undergoing elective or emergency surgery under general anaesthesia, receiving any active or passive warming intervention perioperatively were included. Selection, risk of bias assessment and data extraction were performed by two review authors, independently. Outcomes studied were SSI (primary outcome), inpatient morta...
Journal of Cardiothoracic and Vascular Anesthesia, 1996
Background. Mild perioperative hypothermia, which is common during major surgery, may promote surgical-wound infection by triggering thermoregulatory vasoconstriction, which decreases subcutaneous oxygen tension. Reduced levels of oxygen in tissue impair oxidative killing by neutrophils and decrease the strength of the healing wound by reducing the deposition of collagen. Hypothermia also directly impairs immune function. We tested the hypothesis that hypothermia both increases susceptibility to surgical-wound infection and lengthens hospitalization. Methods. Two hundred patients undergoing colorectal surgery were randomly assigned to routine intraoperative thermal care (the hypothermia group) or additional warming (the normothermia group). The patients' anesthetic care was standardized, and they were all given cefamandole and metronidazole. In a double-blind protocol, their wounds were evaluated daily until discharge from the hospital and in the clinic after two weeks; wounds containing culture-positive pus were considered infected. The patients' surgeons remained unaware of the patients' group assignments. Results. The mean (Ϯ SD) final intraoperative core temperature was 34.7 Ϯ 0.6 Њ C in the hypothermia group and 36.6 Ϯ 0.5 ° C in the normothermia group (P Ͻ 0.001). Surgical-wound infections were found in 18 of 96 patients assigned to hypothermia (19 percent) but in only 6 of 104 patients assigned to normothermia (6 percent, P ϭ 0.009). The sutures were removed one day later in the patients assigned to hypothermia than in those assigned to normothermia (P ϭ 0.002), and the duration of hospitalization was prolonged by 2.6 days (approximately 20 percent) in the hypothermia group (P ϭ 0.01). Conclusions. Hypothermia itself may delay healing and predispose patients to wound infections. Maintaining normothermia intraoperatively is likely to decrease the incidence of infectious complications in patients undergoing colorectal resection and to shorten their hospitalizations.
Experimental study of delivery of humidified-warm carbon dioxide during open abdominal surgery
British Journal of Surgery
Background The aim of this study was to monitor the effect of humidified-warm carbon dioxide (HWCO2) delivered into the open abdomen of mice, simulating laparotomy. Methods Mice were anaesthetized, ventilated and subjected to an abdominal incision followed by wound retraction. In the experimental group, a diffuser device was used to deliver HWCO2; the control group was exposed to passive air flow. In each group of mice, surgical damage was produced on one side of the peritoneal wall. Vital signs and core temperature were monitored throughout the 1-h procedure. The peritoneum was closed and mice were allowed to recover for 24 h or 10 days. Tumour cells were delivered into half of the mice in each cohort. Tissue was then examined using scanning electron microscopy and immunohistochemistry. Results Passive air flow generated ultrastructural damage including mesothelial cell bulging/retraction and loss of microvilli, as assessed at 24 h. Evidence of surgical damage was still measurable ...
Warmed humidified inspired oxygen accelerates postoperative rewarming* 1
Journal of clinical …, 2000
Study Objective: To investigate the efficacy of warmed, humidified inspired oxygen (O 2) for the treatment of mildly hypothermic postoperative patients. Design: Prospective, randomized, unblinded clinical trial. Setting: Postanesthesia care unit in a tertiary care hospital. Patients and Interventions: 30 ASA physical status I, II, and III patients following intraabdominal surgical procedures were randomly assigned to receive either routine O 2 therapy (control group, n ϭ 15), or warmed (42°C) humidified O 2 (treatment group, n ϭ 15) for the initial 90 postoperative minutes. Measurements: Core (tympanic) temperature, dry mouth score and shivering score. Main Results: Tympanic temperature was similar in both groups on admission (Ϸ35.8°C). Rewarming rate in the first postoperative hour was greater in the treatment group (0.7 Ϯ 0.1°C ⅐ hr Ϫ1) compared to the control group (0.4 Ϯ 0.1°C ⅐ hr Ϫ1) (p ϭ 0.03). Patients receiving the warmed, humidified O 2 had a lower incidence of dry mouth compared to the control group (p ϭ 0.03). The incidence of shivering was low and similar in both groups. Conclusions: Warming and humidifying inspired O 2 hastens recovery from hypothermia in postoperative patients.