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Warming Surgical Wounds: Effects on Healing and Wound Complications
Author(s) -
Whitney J.D.,
Dellinger E. P.,
Wickline M.
Publication year - 2004
Publication title -
wound repair and regeneration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.847
H-Index - 109
eISSN - 1524-475X
pISSN - 1067-1927
DOI - 10.1111/j.1067-1927.2004.0abstractw.x
Subject(s) - medicine , hydroxyproline , wound healing , incidence (geometry) , surgery , randomized controlled trial , surgical wound , anesthesia , physics , optics
Aims : Compare postoperative local warming to standard incision care on: 1) healing response and 2) incidence of wound complications. Methods : This two group randomized pilot study (N = 54) tested the wound healing effects of post‐operative warming in patients having gastric bypass or colectomy procedures. Patients randomized to warming received their first 1‐hour treatment in the post anesthesia recovery unit followed by 5 additional treatments in the first 48 hours after surgery. Healing response was evaluated by hydroxyproline and mRNA for pro α 1(I) collagen content of a subcutaneous ePTFE implant removed on postoperative day 9. Patients were followed for the first two postoperative clinic visits (6–8 weeks). CDC Surgical Site Infection Criteria were used to evaluate wound infection and complications. Results : Six warmed (22%) and 10 standard care (37%) patients experienced healing problems. Incidence of Wound Infection by CDC classification.
Incidence of Wound Infection by CDC classification.
Group Superficial Deep Incisional Organ SpaceWarming 2 3 1 Standard Care 4 4 2Mean hydroxyproline levels did not differ, though there was a trend toward higher amounts in warmed patients (332 ± 185 ng/cm ePTFE vs. 286 ± 165 ng/cm). Differences in mRNA for pro α 1(I) collagen approached significance (Chi‐Square 5.4, p = .06) with warmed patients showing more cells with abundant positive message. Conclusions . Clinical and cellular outcomes suggest local incision warming may benefit healing by reducing infection and influencing fibroblast collagen production.