title: The role of perioperative warming in surgery: a systematic review.
abstract: OBJECTIVE
  The objective of this review was to systematically analyze the trials on the effectiveness of perioperative warming in surgical patients.
  
  
  METHODS
  A systematic review of the literature was undertaken. Clinical trials on perioperative warming were selected according to specific criteria and analyzed to generate summative data expressed as standardized mean difference (SMD).
  
  
  RESULTS
  Twenty-five studies encompassing 3,599 patients in various surgical disciplines were retrieved from the electronic databases. Nineteen randomized trials on 1785 patients qualified for this review. The no-warming group developed statistically significant hypothermia. In the fixed effect model, the warming group had significantly less pain and lower incidence of wound infection, compared with the no-warming group. In the random effect model, the warming group was also associated with lower risk of post-anesthetic shivering. Both in the random and the fixed effect models, the warming group was associated with significantly less blood loss. However, there was significant heterogeneity among the trials.
  
  
  CONCLUSIONS
  Perioperative warming of surgical patients is effective in reducing postoperative wound pain, wound infection and shivering. Systemic warming of the surgical patient is also associated with less perioperative blood loss through preventing hypothermia-induced coagulopathy. Perioperative warming may be given routinely to all patients of various surgical disciplines in order to counteract the consequences of hypothermia.
authors.affiliation: Department of Colorectal Surgery, Worthing Hospital, Worthing, West Sussex, United Kingdom. surgeon1wrh@hotmail.com
authors.forename: Muhammad Shafique
authors.initials: MS
authors.lastname: Sajid
authors.forename: Ali Jabir
authors.initials: AJ
authors.lastname: Shakir
authors.forename: Kamran
authors.initials: K
authors.lastname: Khatri
authors.forename: Mirza Khurrum
authors.initials: MK
authors.lastname: Baig
mesh_terms: D001833:Body Temperature Regulation / Q000502:physiology; D006801:Humans; D007035:Hypothermia / Q000517:prevention & control*; D019990:Perioperative Care / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic