Effect of Thermal Reﬂective Blanket Placement on Hypothermia in Primary Unilateral Total Hip or Knee Arthroplasty Marijn Ko€ eter, MS, Borg Leijtens, MD, Sander Ko€ eter, MD, PhD Purpose: Hypothermia in patients undergoing major clean surgery re- sults in higher incidence of perioperative complications. The aim of this study was to evaluate whether the additional use of a thermal reﬂective blanket can prevent hypothermia in patients undergoing primary unilat- eral total hip or knee replacement surgery. Design: A randomized, single-blinded study design was used. Methods: A total of 58 patients were randomized, 29 received a thermal reﬂective blanket, and 29 did not. Outcome measures included core tem- perature, thermal comfort, and shivering. Findings: The mean of the lowest core temperature was below 36  C in both the groups (35.9 6 0.4  C vs 35.8 6 0.4  C); thermal comfort and shivering were not signiﬁcantly different between the groups. Conclusions: A thermal reﬂective blanket did not prevent hypothermia in this group of patients. Keywords: hypothermia, warming devices, arthroplasty, temperature monitoring, thermal reﬂective, research. Ó 2013 by American Society of PeriAnesthesia Nurses POSTOPERATIVE HYPOTHERMIA IS a common and serious complication in patients under- going major surgery. Several prospective random- ized trials 1-4 have quantiﬁed the consequences of hypothermia on postoperative complications in clean surgery. A core temperature drop of only 1.9  C triples the risk of wound infection. 2,3 Mild hypothermia causes coagulopathy and can lead to increases in blood loss and allogenic transfusion requirements. Perioperative mild hy- pothermia prolongs postanesthesia care unit (PACU) length of stay and patients experience more thermal discomfort. 1,4 Even hospitalization duration can be signiﬁcantly prolonged owing to hypothermia. 1,2,5 Normothermia is an important deterrent to these adverse effects. Hypothermia occurs owing to the anesthetic- induced impairment of thermoregulatory control and exposure to a cool operating room environ- ment. 1,4 To avoid a drop in body temperature as a result of the surgical procedure, several measures can be taken, including the use of a thermal reﬂective blanket (Thermoﬂect blanket; Encompass Group, LLC, McDonough, GA). This Thermoﬂect blanket is made of material that reﬂects a patient’s endogenous radiant heat to prevent cooling of the patient during the surgical procedure. The blanket is lightweight, comfortable, durable, and relatively cheap. 4 The Marijn Ko€ eter, MS, is a Medical Student, University Maas- tricht, Maastricht, The Netherlands; Borg Leijtens, MD, is a Medical Doctor, Department of Orthopaedic Surgery, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands; and Sander Ko€ eter, MD, PhD, is a Doctor of Medicine, Depart- ment of Orthopaedic Surgery, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands. Conﬂict of interest: None. Address correspondence to Borg Leijtens, Department of Or- thopaedic Surgery, Canisius-Wilhelmina Hospital, Weg door Jonkerbos 100, 6532 SZ Nijmegen, The Netherlands; e-mail address: borgleijtens@hotmail.com. Ó 2013 by American Society of PeriAnesthesia Nurses 1089-9472/$36.00 http://dx.doi.org/10.1016/j.jopan.2012.08.007 Journal of PeriAnesthesia Nursing, Vol 28, No 6 (December), 2013: pp 347-352 347