Reducing Implant Infection in Orthopaedics (RIIiO): Results of a Pilot Study Comparing the Influence of Forced Air and Resistive Fabric Warming Technologies on Post-Operative Infections following Orthopaedic Implant Surgery.

Kümin, Michelle and Deery, Joanne and Turney, Sharon and Price, Carly and Vinayakam, Parthiban and Smith, Andrew and Filippa, Athanasia and Wilkinson-Guy, Lisa and Moore, Faye and O'Sullivan, Mary and Dunbar, Mark and Gaylard, Jane and Newman, Julie and Harper, Christopher Mark and Minney, Debbie and Parkin, Charlotte and Mew, Louise and Pearce, Oliver and Third, Kerry and Shirley, Helen and Reed, Mike and Jefferies, Lorrayne and Hewitt-Gray, Jillian and Scarborough, Claire and Lambert, Debbie and Jones, Christopher Iain and Bremner, Stephen and Fatz, Duncan and Perry, Nicky and Costa, Matthew and Scarborough, Matthew (2019) Reducing Implant Infection in Orthopaedics (RIIiO): Results of a Pilot Study Comparing the Influence of Forced Air and Resistive Fabric Warming Technologies on Post-Operative Infections following Orthopaedic Implant Surgery. The Journal of hospital infection. ISSN 1532-2939.

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Official URL: https://www.journalofhospitalinfection.com/article...

Abstract

BACKGROUND

Active warming during surgery prevents perioperative hypothermia but the effectiveness and post-operative infection rates may differ between warming technologies. We report results of a pilot study in patients over the age of 65 undergoing hemiarthroplasty following fractured neck of femur.

AIM

To establish the recruitment and data management strategies needed for a full trial comparing post-operative infection rates associated with forced air versus resistive fabric warming.

METHODS

Participants were randomised 1:1 in permuted blocks to forced air or resistive fabric warming. Hypothermia was defined as a temperature of <36ºC at the end of surgery. Primary outcomes were the number of participants recruited and the number with definitive deep surgical site infections.

FINDINGS

515 participants were randomised at 6 sites over a period of 18 months. Follow-up was completed for 70.1%. Thirty-seven participants were hypothermic (7.5% in the FAW group; 9.7 % in the RFW group). The mean temperatures before anaesthesia and at the end of surgery were similar. For the primary clinical outcome, there were 4 deep surgical site infections in the forced air warming group and 3 in the resistive fabric warming group. All participants who developed a post-operative infection had antibiotic prophylaxis, a cemented prosthesis and were operated under laminar airflow; none were hypothermic. There were no serious adverse events related to warming.

CONCLUSION

Surgical site infections were identified in both groups. Progression from the pilot to the full trial is possible but will need to take account of the high attrition rate.

TRIAL REGISTRATION

ISRCTN 74612906 (http://www.isrctn.com/ISRCTN74612906).

Item Type: Article
Subjects: WE Musculoskeletal. Orthopaedics
Divisions: Clinical Support > Infection Control
Related URLs:
Depositing User: Jennifer Manders
Date Deposited: 20 Sep 2019 11:51
Last Modified: 20 Sep 2019 11:51
URI: http://www.repository.uhblibrary.co.uk/id/eprint/2405

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