Comparing surgical site infection with and without the use of forced-air warming devices during surgical procedures: a systematic review and meta-analysis

Forced-air warming (FAW) is effective in preventing hypothermia, yet its impact on surgical site infections (SSI) remains debated. This systematic review synthesizes available evidence on the impact of FAW devices on SSI incidence among surgical patients. We searched CINAHL, EMBASE, Medline, and CENTRAL databases. Fourteen included studies were randomized controlled trials (RCTs), non-randomized controlled trials, and observational studies comparing FAW devices to other warming methods or no warming in adult patients undergoing elective or emergency surgeries. The Effective Public Health Practice Project (EPHPP) tool was used for quality assessment, and a narrative synthesise and meta-analysis was performed. Fourteen studies met the inclusion criteria. The pooled analysis did not show a significant increase in SSI risk with FAW use. However, heterogeneity in study designs and small sample sizes limit the generalizability of findings. Future research should focus on larger, multicenter RCTs in diverse surgical settings and documenting patient characteristics and anaesthetic methods.