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Editor's Page: Does Forced-Air Warming Increase SSI Risk?
The inventor of the Bair Hugger now claims it's dangerous.
Dan O'Connor
Publish Date: October 5, 2015   |  Tags:   Editors Page
OR Excellence

We're excited to announce that next year's OR Excellence will take place at the beautiful Hyatt Regency Coconut Bay resort in sunny Bonita Springs, Fla. We're taking over the entire hotel, so everyone you meet will be part of the ORX family. The gathering will begin 2 days after Columbus Day, so turn the long weekend into an extended getaway filled with learning and fun. Come for the informative educational sessions and opportunity to network with surgical leaders from around the country, and stay for some much-deserved relaxation in the resort's spa, by its stunning pool or on its championship 18-hole golf course. Visit orexcellence.com for more information and to register for surgery's can't-miss conference.

If we are to believe the allegations in the recent spate of Bair Hugger lawsuits that forced-air warmers can cause deep joint infections in orthopedic implant surgery patients by stirring up "contaminated waste heat" from the OR floor and then lifting the airborne germs alongside the OR table and depositing them into the sterile surgical field, then you should wheel your Bair Huggers into the storage closet and use them as lead apron hangers.

But if these lawsuits — more than 20 have been filed at last count in what appears to be a well-organized mass tort litigation — turn out to be a bunch of hot air, then by all means keep doing what you've been doing: warming patients before, during and after surgery to provide comfort and to stave off infection.

An odd set of circumstances surrounds the lawsuits. 3M's Bair Hugger has been around since 1987, and has been used to warm more than 200 million patients in surgery centers and hospitals around the world. The world's most popular patient warming device is under attack by none other than Scott D. Augustine, MD, the anesthesiologist who invented it.

"We didn't recognize the problem when I was running the company and remarkably over 20 years no one else did either. About 6 years after I left the company, we accidentally discovered the unintended consequence of forced-air warming," says Dr. Augustine.

Today, Dr. Augustine is CEO of Augustine Temperature Management, maker of the air-free conductive fabric warming HotDog devices. He points to 6 studies that have been published in the past 4 years that he says prove the waste heat contamination problem. The readers we polled aren't so sure. As you can see in the "InstaPoll" box on the lower left, our survey ended in a virtual dead heat when we asked nearly 300 readers if forced-air patient warmers can cause SSIs.

OSM logo

Can forced-air patient warmers cause surgical site infections?

  • yes 34%
  • no 33%
  • unsure 33%

SOURCE: Outpatient Surgery Magazine, September 2015, n=279

"Multiple independent organizations including the 2013 International Consensus Meeting on Periprosthetic Joint Infection (PJI) and the ECRI Institute have specifically investigated competitor claims echoed by these lawsuits, and found that there is no evidence that forced-air warming increases the risk of infection," says 3M lawyer Christiana P. Jacxsens of Greenberg Traurig in Atlanta, Ga.

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Mark Green, CRNA, MSN

From patient safety to staff safety and a painful reminder to practice safe surgery. We share this selfie of Mark Green, CRNA, MSN, of Springfield, Vt., and his ruptured bursa. Last month, Mr. Green was walking down the OR hallway when suddenly his feet went out from under him and he landed hard on his rear end and elbow. Turns out somebody thought it was a good idea to toss some liquid (most likely surgical irrigation, says Mr. Green) in the trash. "Carrying out the trash, the bag had a leak and it was all over the floor," says Mr. Green. "Not seeing it, it was an assassin just waiting for me."