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Nursing Journal: Forced-Air Warmers May Allow Pathogens to Contact Surgical Wounds
AORN Journal, noting concerns about infection risk from forced-air warmers, called for multi-center, randomized, controlled trials. Evidence of bacteria in the air-flow paths of forced-air warmers; authors ask manufacturers to consider redesign.
· “Clinicians should take steps to prevent health care–associated infections from the use of forced-air warmers….”
· Five separate studies suggested that forced-air warmers could be harboring bacteria or bacteria-containing particles.
Among the research considered by the authors was “Forced-air warming and ultra-clean ventilation do not mix: an investigation of theatre ventilation, patient warming and joint replacement infection in orthopaedics,”
“High risk of developing deep infections for subjects warmed with forced-air warming systems (odds ratio, 3.8; P=.024”
Because of “methodological problems” in the published investigations, however, the authors stated, “the evidence we reviewed does not conclusively indicate that forced-air warmers are the cause of SSIs [surgical-site infections].”
At least one lawsuit already has been filed against 3M, the manufacturer of Bair Hugger forced-air warming. The plaintiff, a 70-year-old man from Houston, underwent 15 revisions after the Bair Hugger system allegedly caused an infection during total hip replacement surgery. Although the plaintiff avoided amputation, he remains severely disabled. The Petition claims damages in excess of $1 million.
More than 50,000 forced-air warming units are currently in use across the country, and the technology is used in almost all total joint replacement surgeries. According to the Houston plaintiff’s attorney, many more cases are likely to be filed. Several plaintiffs’ firms have begun advertising for patients potentially injured by Bair Hugger.
Dr. Scott Augustine, inventor of Bair Hugger warming, defends the device, claiming that it is “probably safe in soft-tissue surgeries. The risk to patients only occurs with implanted devices,” he says, “ like artificial joints. In those surgeries, a single bacteria landing on the device can secrete a biofilm, making it impervious to antibiotics and antibodies. The infection can erupt weeks later. In those cases, the pathogen usually arrives through the air.
“In soft tissue surgeries,” Dr. Augustine concluded, “the risk of infection from FAW is much less.”
StopSurgicalInfections (SSI) is dedicated to educating healthcare professionals about the risks and consequences of surgical infections infections. SSI monitors scientific publications for research relating to such infections, with particularly emphasis on peri-prosthetic infections. SSI is supported by Augustine Temperature Management.
About AORN Journal (from their website)
“The AORN Journal provides professional perioperative registered nurses with evidence-based practice information needed to help meet the physiological, behavioral, safety, and health system needs of a diverse patient population. Journal content supports the clinical, research/quality improvement, education, and management strategies related to the nurses role in caring for patients before, during, or after operative and other invasive and interventional procedures in ambulatory and inpatient settings.”