The impact of perioperative hypothermia on plastic surgery outcomes: A multivariate logistic regression of 1062 cases

Abstract

Background: Perioperative hypothermia has been associated with increased rates of infection, prolonged recovery time, and coagulopathy. Objectives: The authors assessed the impact of hypothermia on patient outcomes after plastic surgery and analyzed the impact of prewarming on postoperative outcomes. Methods: The medical charts of 1062 patients who underwent complex plastic surgery typically lasting at least 1 hour were reviewed. Hypothermia was defined as a temperature at or below 36°C. Postoperative complication data were collected for outcomes including infection, delayed wound healing, seroma, hematoma, dehiscence, deep venous thrombosis, and overall wound problems. Odds ratios (ORs) were estimated from 3 multivariate logistic regression models of hypothermia and one model of body contouring procedures that included prewarming as a parameter. Results: Perioperative hypothermia was not a significant predictor of wound problems (OR = 0.83; P =.28). In the stratified regression model, hypothermia did not significantly impact wound problems. The regression model measuring the interaction between hypothermia and operating time did not show a significantly increased risk of wound problems. Prewarming did not significantly affect perioperative hypothermia (P =.510), and in the model of body contouring procedures with prewarming as a categorical variable, massive weight loss was the most significant predictor of wound complications (OR = 2.57; P =.003). Prewarming did not significantly affect outcomes (OR = 1.49; P =.212). Conclusions: Based on univariate and multivariate models in our study, mild perioperative hypothermia appears to be independent of wound complications.