RESUMO
OBJECTIVE: To determine whether the application of warmth after hernia surgery reduces pain and aids wound healing. METHOD: Forty-five patients were recruited and randomised to receive either no warming;two hours of warming immediately after surgery; or seven days of warming. RESULTS: Postoperative pain scores were significantly lower after two hours of warming immediately after surgery compared with the non-warmed patients (p<0.05). Pain scores were lower on each of the first seven postoperative days in the warmed groups compared with the non-warmed subjects. Patients in the warmed groups also had lower ASEPSIS wound scores. CONCLUSION: Warming may allow wounds to heal with fewer complications. In addition, warming for only two hours immediately after surgery may provide similar benefits to seven days of warming.
Assuntos
Hérnia Inguinal/cirurgia , Hipertermia Induzida/métodos , Dor Pós-Operatória/terapia , Cicatrização/fisiologia , Adulto , Feminino , Seguimentos , Hérnia Inguinal/diagnóstico , Temperatura Alta/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Dor Pós-Operatória/diagnóstico , Satisfação do Paciente , Cuidados Pós-Operatórios/métodos , Probabilidade , Valores de Referência , Fatores de Risco , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
Systemic and local warming may accelerate wound healing and minimise postoperative wound infection, although more research is needed to confirm this. The existing evidence of the benefits of warming therapies is outlined here.
Assuntos
Temperatura Alta/uso terapêutico , Cicatrização/fisiologia , Ferimentos e Lesões/fisiopatologia , Ferimentos e Lesões/terapia , Doença Crônica , Humanos , Hipotermia/prevenção & controle , Sistema Imunitário/fisiopatologia , Oxigênio/metabolismo , Assistência Perioperatória/métodos , Ferimentos e Lesões/imunologia , Ferimentos e Lesões/metabolismoRESUMO
BACKGROUND: Wound infection after clean surgery is an expensive and often underestimated cause of patient morbidity, and the benefits of using prophylactic antibiotics have not been proven. Warming patients during colorectal surgery has been shown to reduce infection rates. We aimed to assess whether warming patients before short duration, clean surgery would have the same effect. METHODS: 421 patients having clean (breast, varicose vein, or hernia) surgery were randomly assigned to either a non-warmed (standard) group or one of two warmed groups (local and systemic). We applied warming for at least 30 min before surgery. Patients were followed up and masked outcome assessments made at 2 and 6 weeks. FINDINGS: Analysis was done on an intention-to-treat basis. We identified 19 wound infections in 139 non-warmed patients (14%) but only 13 in 277 who received warming (5%; p=0.001). Wound scores were also significantly lower (p=0.007) in warmed patients. There was no significant difference in the development of haematomas or seromas after surgery but the non-warmed group were prescribed significantly more postoperative antibiotics (p=0.002). INTERPRETATION: Warming patients before clean surgery seems to aid the prevention of postoperative wound infection. If applied according to the manufacturers guidelines these therapies have no known side-effects and might, with the support of further studies, provide an alternative to prophylactic antibiotics in this type of surgery.