What is HotDog Patient Warming?

Air-free HotDog patient warming is safer for surgeries involving implanted foreign materials—such as orthopedic and cardiac surgery—because there is no waste heat disrupting the sterile field with contaminants. Rising waste heat from forced-air warming contaminates the sterile surgical field above the table with dirty air from the floor by generating convection currents. There is an increasing body of peer-reviewed evidence published on this issue. (Research)

Click for the full Cleaning Guidelines. The cleaning process takes 30 seconds or less. The blankets can be cleaned in the OR by wiping with a low- to intermediate-level disinfectant—whatever is currently used to wipe surfaces like the OR table. The blankets are designed for easy cleaning: the outer shell is non-porous and heat-sealed to eliminate crevices. The CDC says noncritical items (only come in contact with intact skin) like HotDog blankets are safe and present virtually no risk of cross-contamination. Also, HotDog cables are much easier to wipe down than a forced-air warming corrugated hose. For more information see this video on cleaning:

Yes. The heater fabric is completely radiolucent. However, each warming blanket and mattress has parallel buss bars that run along the long edge of the warming device. These can be seen on x-ray. In addition, the area around the sensor is also radio-opaque. See the Underbody Warming brochure (M106C) for a diagram of the radiolucent areas of a warming mattress. If x-raying will be done (through the chest cavity, for example) then the mattress should be positioned such that the imaging area does not contain the sensor or buss bar.

The U5XX series combines both patient warming and electrosurgical grounding, so there is no need for an additional return electrode pad.

However, when using the U1XX series, placing mattress underneath the grounding pad will diminish the thermal effects of the HotDog mattress. If the warming mattress is on top of the grounding pad, the surgeon may see a diminished effect at the active electrode. There is usually an indication from the grounding pad controller if there is not a good ground. Consult with the grounding pad manufacturer for more specifics.

The most successful approach is to stagger the mattress and the grounding pad. Make sure the HotDog mattress’s sensor is in contact with the patient’s torso for best warming results.

Yes. Procedures where the patient is positioned in steep Trendelenburg historically result in high rates of hypothermia due to the small surface area available for warming. The HotDog Waffle-Grip Trendelenburg positioning accessory effectively prevents the patient from sliding on the table while still providing warmth under the patient.

Published research shows a 74% reduction in deep joint infections after discontinuing the use of forced-air patient warming. Ventilation disruption was associated with a significant increase in deep joint infections for FAW versus patient groups in which forced-air warming was discontinued and patients were warmed with conductive fabric blankets and mattresses. (N=1,437 cases; 2-5 years period P=0.028) Click here for an abstract of the study. (JBJS study abstract)

No. Consult Cleaning and Safety Information for more detail. HotDog products are considered “non-critical items,” meaning they only come in contact with intact skin. According to the CDC, “Virtually no risk has been documented for transmission of infectious agents to patients through noncritical items…” Another thing to consider is that the risk of contamination may actually be greater with FAW. FAW is only partially disposable. The blower and hose are used with thousands of different patients, sometimes moving from one OR to another. One published study showed that 92% of FAW blowers are contaminated with bacteria, and 58% internally generated and emitted germ-sized particles (Albrecht, AJIC, 2011). The contamination is significant because high-velocity air blows across the germ colonies. The contaminated hot air vents under the drapes, mixes with “dirty” floor air and rises into the sterile field.

HotDog blankets are ideally suited for pre- and post-op warming. Lower or full-body blankets can provide active warmth for as low as $1/patient. It’s a much less expensive option than disposable forced-air warming gowns or piles of warmed cotton blankets. (Savings)

HotDog offers an underbody warming mattress that can be placed on the OR table and used to warm patients from below. Underbody warming is great at preventing heat loss and maintaining patients’ core temperature. Effective rewarming requires blankets, which can be used in conjunction with a mattress. Details are found here.