The influence of operating room temperature and humidity on surgical site infection: A multisite ACS-NSQIP analysis

Background: Literature evaluating intraoperative temperature/humidity and risk of surgical site infection (SSI) is lacking. Methods: All operations at three centers reported to the ACS-NSQIP were reviewed (2016-2020); ambient intraoperative temperature (degrees F) and relative humidity (RH) were recorded in 15-min intervals. The primary endpoint was superficial SSI, which was evaluated with multi-level logistic regression. Results: 14,519 operations were analyzed with 179 SSIs (1.2%). The lower/upper 10th percentiles for temperature and RH were 64.4/71.4 degrees F and 33.5/55.5% respectively. Low or high temperature carried no significant increased risk for SSI (Low degrees F OR = 0.95, 95% CI 0.51-1.77, P = 0.86; High degrees F OR = 1.13, 95% CI = 0.69-1.86, P = 0.63). This was also true for low and high RH (Low RH OR = 0.96, 95% CI 0.58-1.61, p = 0.88; High RH OR = 0.61, 95% CI = 0.33-1.14, P = 0.12). Analysis of combined temperature/humidity showed no increased risk for SSI. Conclusion: Significant deviations in intraoperative temperature/humidity are not associated with increased risk of SSI. (c) 2023 Elsevier Inc. All rights reserved.