Effects of mild hypothermia on blood coagulation in patients undergoing elective plastic surgery.
BACKGROUND
The aim of this prospective, controlled study was to evaluate the effects on coagulation function of active patient warming during elective plastic surgery.


METHODS
Seventy-six patients undergoing elective plastic surgery (additive and reductive mastoplasty, rhinoplasty, and liposuction) were either covered with standard sterile drapes (control group, n = 38) or actively warmed during surgery with countercurrent fluid warming and forced-air skin warming (treatment group, n = 38). Complete evaluation of the coagulation activity was performed 1 hour before general anesthesia was induced and then at the end of surgery.


RESULTS
Although no differences in preoperative core temperature were observed (36.0 +/- 0.5 degrees C in the control group and 36.1 +/- 0.4 degrees C in the treatment group; p = 0.12), core temperature was lower at the end of surgery in the control group (34 +/- 1.0 degrees C) than in the treatment group (36 +/- 0.6 degrees C) (p = 0.0005). No differences in prothrombin time and fibrinogen plasma concentrations were observed between the two groups. At the end of surgery, control group patients showed significantly larger activated partial thromboplastin times (36.8 +/- 3.5 seconds) and bleeding times (8.1 +/- 1.6 minutes) as compared with patients maintained normothermic during surgery (34.0 +/- 2.9 seconds and 4.3 +/- 1.1 minutes; p = 0.0005 and p = 0.0005, respectively).


CONCLUSIONS
Actively maintaining intraoperative normothermia allows patients to maintain normal coagulation function during elective plastic surgery lasting longer than 2 hours, potentially reducing the occurrence of bleeding-related complications after plastic surgery.
Unit of Plastic Surgery, Galeazzi Hospital, Milan, Italy.
Maurizio
M
Cavallini
Franz Wilhelm
FW
Baruffaldi Preis
Andrea
A
Casati
D000328:Adult; D001777:Blood Coagulation; D001780:Blood Coagulation Tests; D017558:Elective Surgical Procedures; D005260:Female; D006488:Hemostasis, Surgical; D006801:Humans; D007036:Hypothermia, Induced; D015187:Lipectomy; D008297:Male; D011446:Prospective Studies; D019651:Plastic Surgery Procedures; D012225:Rhinoplasty