Efficacy of occlusive wraps used for delivery room care

Abstract

Background: Guidelines advise for more than 20 years to use occlusive plastic wraps for temperature management during delivery room care but data on efficacy of different types of wrap are still scarce.

Methods: A random sample of seven different types of plastic wrap was tested using prewarmed aluminium blocks.

Results: The most effective wrap increased the time to cool by 2°C by one-third for the core and by 100% for the surface whereas the least effective wrap led to even faster heat loss compared with no wrap at all. The least effective wrap concerning all capacities tested was made from polyurethane that contains potentially toxic and narcotic monomers. Heat and water retention did not correlate to wrap thickness.

Discussion: Large differences in heat and water retention capacity warrant a careful choice of the type of wrap as some might be counterproductive. Wraps containing polyurethane should not be used.

Keywords: emergency care; intensive care units; neonatal; toxicology.

Figure 1

Heat loss from a 548 g aluminium block. Shown is the time in which the temperature on the surface (black) and core (grey) of a 548 g aluminium block decreased by 2°C when being wrapped with one of the wraps (A–G) or without a wrap (0).

Figure 2

Water loss and thickness of wraps. Analysis of the seven different wraps showing the amount of water loss from a washcloth soaked with 20 mL of water being wrapped with one of the wraps (A–G) or without a wrap (0), the results of two different thickness measurements, the product description and their material by our analysis. Wrap B was discontinued while the study was in progress, the others are still in use in Germany. PE, polyethylene; PVdC, polyvinylidenechloride; PU, polyurethane.