title: The impact of perioperative hypothermia on plastic surgery outcomes: a multivariate logistic regression of 1062 cases.
abstract: BACKGROUND
  Perioperative hypothermia has been associated with increased rates of infection, prolonged recovery time, and coagulopathy.
  
  
  OBJECTIVE
  The authors assessed the impact of hypothermia on patient outcomes after plastic surgery and analyzed the impact of prewarming on postoperative outcomes.
  
  
  METHODS
  The medical charts of 1062 patients who underwent complex plastic surgery typically lasting at least 1 hour were reviewed. Hypothermia was defined as a temperature at or below 36°C. Postoperative complication data were collected for outcomes including infection, delayed wound healing, seroma, hematoma, dehiscence, deep venous thrombosis, and overall wound problems. Odds ratios (ORs) were estimated from 3 multivariate logistic regression models of hypothermia and one model of body contouring procedures that included prewarming as a parameter.
  
  
  RESULTS
  Perioperative hypothermia was not a significant predictor of wound problems (OR = 0.83; P = .28). In the stratified regression model, hypothermia did not significantly impact wound problems. The regression model measuring the interaction between hypothermia and operating time did not show a significantly increased risk of wound problems. Prewarming did not significantly affect perioperative hypothermia (P = .510), and in the model of body contouring procedures with prewarming as a categorical variable, massive weight loss was the most significant predictor of wound complications (OR = 2.57; P = .003). Prewarming did not significantly affect outcomes (OR = 1.49; P = .212).
  
  
  CONCLUSIONS
  Based on univariate and multivariate models in our study, mild perioperative hypothermia appears to be independent of wound complications. LEVEL OF EVIDENCE 4: Risk.
authors.affiliation: From the Department of Plastic and Reconstructive Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Ryan S
authors.initials: RS
authors.lastname: Constantine
authors.affiliation: From the Department of Plastic and Reconstructive Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Matthew
authors.initials: M
authors.lastname: Kenkel
authors.affiliation: From the Department of Plastic and Reconstructive Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Hein
authors.affiliation: From the Department of Plastic and Reconstructive Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Roberto
authors.initials: R
authors.lastname: Cortez
authors.affiliation: From the Department of Plastic and Reconstructive Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Kendall
authors.initials: K
authors.lastname: Anigian
authors.affiliation: From the Department of Plastic and Reconstructive Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Davis
authors.affiliation: From the Department of Plastic and Reconstructive Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Kenkel
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001833:Body Temperature Regulation; D003357:Cosmetic Techniques / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007035:Hypothermia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D061646:Operative Time; D059035:Perioperative Period; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013530:Surgical Wound Infection / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult