Infection Risk from Forced-air Warming Considered; Study on Bacterial Contamination Recommended

International Orthopedic Consensus 

“We recognize the theoretical risk posed by forced air warming blankets,” concluded the Consensus Statement recently released by the International Consensus on Periprosthetic Joint Infection.  While not urging a change in practice, the Consensus Statement recommended that further studies be undertaken regarding the safety of forced-air warming (“FAW”) in orthopedic implant surgery.
Delegates from more than 50 countries and 80 different societies met in August 2013 to evaluate scientific literature and identify areas for further research.  Among the other conclusions relating to periprosthetic joint infections and the risk of airborne contamination:
 
1. Airborne particulate bacteria are a major source of contamination in the operating room.  The number of airborne bacteria around the wound is correlated to the incidence of periprosthetic joint infections.  Bacteria “circulate through the operating room via air currents.”

“Legg et al,” the Consensus Statement noted, “found increased particles above the surgical site when using FAW compared to radiant warming.” To be precise, the Legg study, published in Bone & Joint Journal, found 2,000 times more contaminant particles in the air over the wound with Bair Hugger forced-air warming than with air-free HotDog conductive warming.  With HotDog patient warming, only 1,000 particles per cubic meter of air were present. With Bair Hugger warming, the particle count was 2,174,000 per cubic meter, an increase of 217,300%.