Are CRNAs Inadvertently Contributing to Post-operative Wound Infections? The Potential Contamination of Skin by the Use of a Forced Air Warming Device

Abstract

Purpose: The purpose of this study was to examine the use of 3M Corporation's Bair Hugger® forced air warming (FAW) device and the transfer of potentially infectious material to the patient's skin. Methods: After receiving approval from 2 IRBs, 31 patients undergoing surgical procedures that would benefit from active warming were consented for this study. Per the study protocol, 3 samples were obtained from each subject using contact agar plate sampling. After cleansing the skin and preparing it as for a surgical incision" the first sample was taken directly underneath the nozzle connection for the FAW prior to blanket application. At the termination of the procedure a second sample was taken from the same area and the third sample was taken from the interior of the blanket prior to removing it from the patient. The agar plates were incubated for 48 hours and the plates were inspected for any growth. All plates were examined for any colony forming units (CFUs). The numbers of CFUs were counted for comparison between all 3 samples. Results: Of the 30 patients included in the study, three (10%) had contamination of the skin following removal of the FAW blanket, and the remaining 27 (90%) had no skin contamination. Colony growth was present on the interior of 14 (47%) of the FAW blankets postoperatively. No patient had any postoperative surgical site infections after a 30 day follow up. Conclusion: This study concluded that despite the potential for contamination of the patient's skin the risk of warming each patient with a FAW may outweigh the risks associated with hypothermia.