Normothermia in Arthroplasty

Abstract

Background: Since the initial design of surgical theatres, the thermal environment of the operating suite itself has been an area of concern and robust discussion. In the 1950s, correspondence in the British Medical Journal discussed the most suitable design for a surgeon's cap to prevent sweat from dripping onto the surgical field. These deliberations stimulated questions about the effects of sweat-provoking environments on the efficiency of the surgical team, not to mention the effects on the patient. Although these benefits translate to implant-based orthopedic surgery, they remain poorly understood and, at times, ignored.

Methods: A review and synthesis of the body of literature on the topic of maintenance of normothermia was performed.

Results: Maintenance of normothermia in orthopedic surgery has been proven to have broad implications from bench top to bedside. Normothermia has been shown to impact everything from nitrogen loss and catabolism after hip fracture surgery to infection rates after elective arthroplasty.

Conclusion: Given both the physiologic impact this has on patients, as well as a change in the medicolegal environment around this topic, a general understanding of these concepts should be invaluable to all surgeons.

Keywords: arthroplasty; normothermia; total hip arthroplasty; total knee arthroplasty; warming strategies.