The medical literature indicates that patients undergoing colorectal surgery have a decreased risk of surgical site infection if they are not allowed to become hypothermic during the perioperative period (Melling. Lancet. 2001;358:876). Anesthesia, anxiety, wet skin preparations, and skin exposure in cold operating rooms can cause patients to become clinically hypothermic during surgery. The relatively limited clinical data are supported by strong theoretical rationale and experimental data. Some experts believe that initial efforts should be directed at colorectal surgery patients until additional clinical studies are performed. However, there is evidence to show that preventing hypothermia is beneficial in reducing other complications, and it clearly is more comfortable for patients.

*NOTE:

1. This component of care is supported by clinical trials and experimental evidence for the specified population (colorectal surgery patients); it may prove valuable for other surgical patients as well.
2. This component of care does not pertain to those patients for whom therapeutic hypothermia is being used (e.g., hypothermic cardioplegia).

Changes for Improvement

• Use warmed forced-air blankets preoperatively, during surgery, and in the post anesthesia care unit (PACU)
• Use warmed IV fluids
• Use warming blankets under patients on the operating table
• Use hats and booties on patients perioperatively
• Adjust engineering controls so that operating rooms and patient areas are not permitted to become excessively cold overnight, when many rooms are closed
• Designate responsibility and accountability for thermoregulation