Perioperative body temperature maintenance and occurrence of surgical site infection: A systematic review with meta-analysis

Background: Current guidelines recommend perioperative warming as one of the strategies to prevent surgical site infection, although there are gaps in the knowledge produced on this issue. Aim: Assess the efficacy of active warming methods to maintain perioperative patients' body temperature and its effect on the occurrence of surgical site infection. Methods: A systematic review with meta-analysis was carried out. PubMed, CINAHL, LiLACS, CENTRAL, and EMBASE databases were searched. Findings: Of the 956 publications identified, 9 studies were selected for quantitative synthesis and 6 for the meta-analysis. The forced-air warming system was investigated in 8 studies. The generated evidence indicated that the use of an active warming method could maintain higher average body temperature as well as could decrease the surgical site infection incidence. Exposure of the patient to temperatures below 36 degrees C in the perioperative period increased the chances of developing this type of infection. The meta-analysis indicated that the association between perioperative active warming methods compared with others to reduce the chances of developing surgical site infection remains unclear (odds ratio = e (3.59) = 2.718 (0.59) = 0.552, 95% confidence interval (odds ratio) = (0.269-1.135), P= 0.106 I-2 = 54.34%). Conclusions: The employment of an active warming method is effective to maintain higher averages of body temperature. However, more randomized clinical trials are needed to assess the efficacy of that intervention to prevent surgical site infection. (C) 2020 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.