Reducing Implant Infection in Orthopaedics (RIIiO): Results of a pilot study comparing the influence of forced air and resistive fabric warming technologies on postoperative infections following orthopaedic implant surgery.

Kümin, M and Deery, J and Turney, S and Price, C and Vinayakam, P and Smith, Amanda and Filippa, A and Wilkinson-Guy, Lisa and Moore, F and O'Sullivan, Mary and Dunbar, Mark and Gaylard, J and Newman, J and Harper, C M and Minney, D and Parkin, C and Mew, L and Pearce, O and Third, K and Shirley, H and Reed, M and Jefferies, L and Hewitt-Gray, J and Scarborough, C and Lambert, D and Jones, C I and Bremner, S and Fatz, D and Perry, N and Costa, M and Scarborough, M (2019) Reducing Implant Infection in Orthopaedics (RIIiO): Results of a pilot study comparing the influence of forced air and resistive fabric warming technologies on postoperative infections following orthopaedic implant surgery. The Journal of hospital infection, 103 (4). pp. 412-419. 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 postoperative infection rates may differ between warming technologies.

AIM

To establish the recruitment and data management strategies needed for a full trial comparing postoperative infection rates associated with forced air warming (FAW) versus resistive fabric warming (RFW) in patients aged >65 years undergoing hemiarthroplasty following fractured neck of femur.

METHODS

Participants were randomized 1:1 in permuted blocks to FAW or RFW. Hypothermia was defined as a temperature of <36°C at the end of surgery. Primary outcomes were the number of participants recruited and the number with definitive deep surgical site infections.

FINDINGS

A total of 515 participants were randomized at six 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 four deep surgical site infections in the FAW group and three in the RFW group. All participants who developed a postoperative infection had antibiotic prophylaxis, a cemented prosthesis, and were operated under laminar airflow; none was 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.

Item Type: Article
Subjects: WC Communicabable diseases
WO Surgery
Divisions: Clinical Support > Immunology
Clinical Support > Infection Control
Planned IP Care
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Depositing User: Mr Muneeb Liaquat
Date Deposited: 02 Apr 2020 12:48
Last Modified: 02 Apr 2020 12:48
URI: http://www.repository.uhblibrary.co.uk/id/eprint/2951

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