The Aesthetic Surgery Journal, a peer-reviewed publication of the American Society for Aesthetic Plastic Surgery (ASAPS), introduces a patient safety review article that provides evidence-based approaches for preventing perioperative hypothermia—hypothermia that occurs before, during, or after surgery—in aesthetic surgery patients. Aesthetic plastic surgeons are interested in preventing hypothermia because it is a patient safety issue as well as a patient comfort issue.

"Hypothermia is a common but avoidable part of plastic surgery," says Felmont Eaves, MD, chair of the ASAPS Patient Safety Steering Committee, who commissioned the study. "If you’ve had a patient shivering in the surgical recovery area, you’ve had a hypothermic patient, and that’s something we need to keep working to prevent. There is no reason for patients to feel cold at any point before or after surgery. Prevention, which makes procedures safer for patients and saves them from hours of unnecessary pain and discomfort, is not difficult or expensive."

The complications of perioperative hypothermia include increased risk of heart attack and stroke, coagulation disorders and blood loss, surgical wound infections, and postoperative shivering. These events can increase recovery times, hospital stays, and costs. Effective ways to prevent hypothermia in the surgical setting include warming patients preoperatively and during surgery with forced-air heating systems and using fluid warming systems. Other measures include maintaining an ambient operating room temperature of approximately 73°F, covering as much of the patient’s body surface as possible, and aggressively treating postoperative shivering.

Hypothermia prevention is the second issue being tackled by the ASAPS Campaign for Patient Safety, an ongoing initiative to raise awareness of steps that plastic surgeons and their patients can take to improve the safety of cosmetic surgery. The first campaign issue focused on the prevention of venous thromboembolism.

"These campaigns are designed not only to educate ASAPS members, but to also involve related organizations so that nurses, office staff, and our other partners in patient care can work with us to create an integrated culture of safety," says James M. Stuzin, MD, president of ASAPS. "There is a growing awareness among plastic surgeons that hypothermia is an important patient safety issue. Maintaining normothermia keeps patients safer and can completely change a patient’s perception of surgery for the better."

[www.surgery.org, October 31, 2006]