In open surgery, heat is lost due to radiation and evaporation through the
wound.
Hypothermia causes tissue
hypoxia and impairs various cellular immune functions that increases the risk for
postoperative wound infections and delayed wound healing. The patient's body is usually well protected with heating arrangements, but the open
wound is left unprotected and until now no practical method has been available to
protect it thermically. We therefore investigated if insufflation of an open
surgical wound with
carbon dioxide would affect
wound temperature. In 10 patients undergoing cardiac surgery, the
sternotomy wound was insufflated with dry, room temperature
carbon dioxide via a gas diffuser for 2 minutes. A heat-sensitive camera measured the
wound temperature before, during, and after insufflation. Exposure to
carbon dioxide increased the median temperature of the whole
wound by 0.5 degrees C (p=0.01). The temperature of the area distant to the diffuser increased by 1.2 degrees C (p<0.01) whereas in the area close to the diffuser it decreased by 1.8 degrees C (p<0.01). In conclusion, short-term insufflation of dry room temperature
carbon dioxide in an open
wound increases the surface temperature significantly. Although a small increase, it may reduce the incidence of
postoperative wound infections in the future.