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Are Operating Rooms Cold To Prevent Infection?

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Updated April 29, 2014

Question: Are Operating Rooms Cold To Prevent Infection?
I can't tell you how often I hear it in the operating room! A patient asks, "Why is it so cold in here?" And the response, almost invariably, "It helps lower the risk of infection..."
Answer: Problem is, that's completely false! In fact, operating rooms kept cold actually increase the risk of infection! Why is that the case? When a patient's body temperature cools, the risk of infection goes up.

Body Temperature and Infections
It turns out, one of the critical factors to preventing infection, is the adequacy of blood flow and the supply of oxygen to tissues. When in a cold environment, the blood vessels of your skin constrict (that's why your skin turns pale in cold weather). Your body constricts blood vessels in cold environments so as not to waste heat--a process called themoregulation.

Immune Defenses
The second factor is that your immune system is actually weakened by hypothermia. Therefore, maintaining a normal body temperature during surgery will help your body fight infection.

So Why Is It So Cold In The OR?

The real reason operating rooms are kept so cool is for the comfort of OR personnel, specifically the surgeon. When wearing a sterile gown for a length of time, especially while standing under warm OR lights, your surgeon can become quite hot. The room is often kept cool to keep the surgeon and the staff more comfortable.

What can you do?

  • Ask that the room be kept at a reasonable temperature.

  • Let the staff know when you are cold and ask for warm blankets.

  • Special warming devices can be used to keep you warm during surgery while not warming the entire room. Ask your anesthesiologist about using such a device.

Many people, especially OR personnel, are surprised to learn these facts, as it has been thought by many people that cold rooms prevent infection.

Sources:

Kurz A, et al. "Perioperative normothermia to reduce the incidence of surgical-wound infection" New England Journal of Medicine 1996 May 9;334(19):1209-15.

Melling AC, et al. "Effects of preoperative warming on the incidence of wound infection" Lancet 2001 Sep 15;358(9285):876-80.

Sessler DI, Akça O. "Nonpharmacological prevention of surgical wound infections" Clinics of Infectious Disease 2002 Dec 1;35(11):1397-404.

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