SO16. Mitigating Intraoperative Hypothermia in Plastic Surgery: The Need for Multimodal Warming Protocols to Prevent Hypothermia-associated SSIs and Coagulopathy

PURPOSE: This study investigates intraoperative temperature changes in plastic surgery and highlights the need for multimodal warming strategies to prevent hypothermia-associated SSIs and coagulopathy. METHODS: This retrospective analysis reviewed temperature changes in 4,165 patients undergoing surgery under general anesthesia. Pre- and postoperative temperatures were recorded, and multivariable linear regression assessed the link between procedure type and temperature change, adjusting for surgery length and inpatient status. The proportion of patients with postoperative temperatures below 36°C was also compared across procedures. RESULTS: Plastic surgery procedures (n=2194) showed a mean temperature change of -0.34±1.85°C, compared to an increase of 0.06±1.80°C in non-plastic surgery procedures (p<0.001). Multivariate regression analysis revealed that body contouring (p=0.020), pedicled breast reconstruction (p=0.004), revision breast reconstruction (p<0.001), and tissue expander breast reconstruction (p=0.009) were associated with temperature decreases. These procedures also experienced a significant increase in the proportion of patients with a body temperature of <36°C from pre- to postoperation. Longer surgeries (p<0.001) and outpatient procedures (p=0.006) were associated with a lower likelihood of intraoperative temperature decreases. CONCLUSION: Intraoperative hypothermia remains prevalent across many plastic surgery procedures. Significant temperature drops observed in specific procedures, along with high proportion of patients’ postoperative temperatures <36°C, indicate a need for multimodal warming techniques (foil caps, heat moisture exchangers, warm IV fluids, plastic wrap of extremities in addition to forced-air warming devices) to maintain normothermia.