Canadian Study: Surgical Warming Blankets and Link to Infection

Kingston, ONIt’s been a little over a year since a landmark study in Canada revealed the striking number of door openings and closings that occur in an operating theatre during surgery. This potential for entry, migration and movement of pathogens and various bacteria may be exacerbated by the common practice of using warming blankets fed with warm air originating from heat-generating blowers located at the floor, as is the case with the Bair Hugger warming blanket system. Recently, this has led to some patients filing Bair Hugger lawsuits.

The Bair Hugger Warming Blanket was originally developed as a means to keep the patient warm in an otherwise cool operating theatre kept at lower temperatures in an effort to aid in maintaining a sterile environment and helping to keep surgeons and support staff alert – especially during long procedures. Keeping the patient warm has been found to speed healing following the procedure, and is even deemed safer for the patient overall.

The Bair Hugger blanket – which is disposable and changed with every patient – is otherwise supplied with hot air from a blower unit located at the floor, where pathogens and bacteria may collect. The hot, humid air tends to disturb, and collect infectious bacteria that otherwise would do little harm in the floor area, transmitting bacteria with the hot air up to the patient where bacteria could be transferred into the surgical site.

Serious infections are alleged to have occurred, leading to some Bair Hugger Warming Blanket lawsuits. It should be noted that the original designer of the Bair Hugger no longer supports the design, and is now promoting a warming blanket heated electrically. The Bair Hugger is now manufactured and marketed by Arizant Healthcare, a subsidiary of 3M.

It is estimated that some 80 percent of hospitals in the US use the Bair Hugger. It has been reported that the Bair Hugger is also employed at a number of Canadian hospitals.

In a story published in the National Post (09/22/15) last year, reference was made to the fact that patients are frequently administered antibiotics prior to surgery, and all staff is gowned and gloved. Controlled airflow systems work to push sterile air away from the surgical wound. But it is alleged that use of forced air warming systems can reverse the benefit of such controlled airflow systems by transferring heated air up to the patient (draped in the warming blanket) from the floor, where bacteria and pathogens when available, may collect.

Add to this the number of door openings during a surgical procedure – according to the Canadian study, 71 operating theatre door openings on average for each procedure – and suddenly what emerges is a perfect storm of potential infection.

Add to that the fact that hip and knee replacements are among the most frequently-performed procedures in North America given the aging Baby Boomers.

What’s more, according to Canadian researchers led by Dr. Martin Bédard, an orthopedic surgeon at Hôpital de l’Enfant Jésus de Québec, “infection following total joint arthroplasty remains a disastrous complication for both the patient and surgeon,” the study suggests.

“Once the bacteria is in contact with metal, it is very difficult, if not impossible to eradicate with antibiotics alone,” Bédard said. Infections require repeat surgeries and, in some cases, temporary removal of the artificial joint, in order to sterilize the knee.

“As a surgeon, infection is your worst complication,” Bédard said in an email interview with the National Post in Canada last year.

“The misery – because I see a lot of these patients – is significant,” said Dr. Dick Zoutman, a professor at Queen’s University in Kingston and chief of staff at Quinte Health Care in Belleville, Ontario.