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The purpose of this study is to determine if local warming of surgical wounds improves healing and helps prevent infection. The investigators want to see if warming surgical incisions improves oxygen levels and healing in skin close to the incision.
Surgical site infections (SSI) account for 37% of US hospital infections and increase morbidity and cost. High rates (10-22%) of SSI are associated with colorectal surgery and obesity. Bacterial resistance requires oxygen and higher tissue oxygen limits infection in general surgery patients. Control of core and local temperature may increase infection resistance by modulating perfusion, oxygenation, angiogenesis and immune cell responses. Perioperative hypothermia reduces tissue oxygen while normothermia lowers SSI rates. Warming injured tissues locally may offer additional benefit. Warming incisions immediately after surgery and intermittently for two days after gastric bypass or colectomy surgery reduced infection rates in a pilot sample. Systematic study of clinical outcomes and potential mechanisms in a larger study is lacking and is the focus of the current study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Local incision warming | Experimental | Local warming applied to surgical incision for 6 treatments beginning in post anesthesia recovery through the second postoperative day. |
|
| No warming to surgical incision | Active Comparator | Incisions covered with same postoperative dressing as in Arm 1 but without warming treatments. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Warming of surgical incision | Other | A warming pack (chemical activation) is applied to the dressing over the surgical incision, warming to 38 degrees C, for a period of 90 minutes times 6 treatments. The first treatment occurs in the PACU. |
| Measure | Description | Time Frame |
|---|---|---|
| Surgical site infection | Within 6 weeks of the surgical procedure |
| Measure | Description | Time Frame |
|---|---|---|
| Wound tissue response | First 9 days after surgery |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Washington Medical Center | Seattle | Washington | 98195 | United States |
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| ID | Term |
|---|---|
| D013530 | Surgical Wound Infection |
| ID | Term |
|---|---|
| D014946 | Wound Infection |
| D007239 | Infections |
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
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| Warming dressing without actual warming | Other | The same type of surgical incision dressing is used but no warming treatments are administered. |
|
| D013568 |
| Pathological Conditions, Signs and Symptoms |