Background. Hypothermia affects 60% - 90% of anesthetized surgical patients and is associated with an increased incidence of impaired coagulation, wound infection, pressure ulcers, morbid cardiac events, and mortality. Clear evidence on the benefits and limits of various cutaneous warming systems is needed to minimize the dangers of hypothermia and improve the outcomes of surgical care.  

Methods. We searched the 2000 – 2005 timeframe in the CINAHL, EMBASE and Medline databases for reports on randomized, controlled trials of cutaneous warming systems used with adult, elective surgical patients during the intra-operative period. We included studies with adequate information on randomization and attrition in our review.       

Results. Fifteen (15) studies on active cutaneous warming systems meeting the inclusion criteria were reviewed for evidence on patient outcomes, nursing workload, ecological considerations such as waste generation, and overall cost-effectiveness. The warming systems examined included cotton blankets, forced air, circulating water garments, resistive heating blankets, radiant warming devices, circulating water mattresses, and reflective blankets. While the evidence to date suggests that several types of warming systems maintain an acceptable intra-operative body temperature, critical evidence on patient outcomes, nursing workload, ecological load, and cost-effectiveness is minimal or absent.

Conclusions. Nurses need to lead further research on intra-operative warming systems to examine key nursing-sensitive patient outcomes, nursing workload, ecological considerations, and the overall cost-effectiveness of care. The evidence generated through nursing research will enable us to knowledgably plan and deliver safer intra-operative patient care at a cost that our health systems and societies can afford to pay.    

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