Reusable versus disposable forced air warming: A comparative study of thermal performance as a first step toward more sustainable practices

BACKGROUND Perioperative hypothermia increases the risk of surgical complications making effective patient warming essential. Disposable forced air warming blankets, while effective, contribute significantly to healthcare waste and environmental impact. Reusable alternatives may offer similar efficacy while reducing environmental footprint, but their thermal performance requires rigorous evaluation. OBJECTIVE To assess the safety and effectiveness of reusable textile blankets as an alternative to disposable forced air warming blankets, as a first step toward developing more sustainable perioperative practices. DESIGN We conducted an in-vitro, prospective, head-to-head comparison of heating performance in full-body and upper body designs, using three blanket types in a simulated operating-room scenario. Blanket types included disposable single use (DSU), light reusable cotton (LRC) and heavy reusable cotton (HRC). A single forced-air warmer was set to 38 8C for all tests, which simulated both normothermic (37 8C) and hypothermic (25 8C) patient conditions, measuring surface temperatures at six anatomically relevant points across the simulated body. SETTING Laboratory-based simulation in a controlled environment simulating operating room conditions with ambient temperature maintained at 20 ± 0.5 8C. PARTICIPANTS A standardised simulated patient thermal model set to either normothermic (37 8C) or hypothermic (25 8C) conditions. MAIN OUTCOME MEASURE Surface temperature and temperature homogeneity were measured at six anatomically relevant points across the simulated body. RESULTS The heavy cotton blanket provided the highest and most homogenous surface temperature in full-body designs (36.7 ± 0.6 8C) (DSU = 35.4 ± 1.1 8C; LRC = 35.7 ± 1.7 8C) (P < 0.05) and upper body designs (35.5 ± 0.5 8C) (DSU = 35.4 ± 0.5 8C; LRC = 34.9 ± 2.4 8C) (P < 0.05). Unsafe temperature elevations were not recorded for any of the test configurations. The statistical analysis revealed significant differences between blanket types (P < 0.05), with heavy reusable cotton consistently outperforming both disposable single-use and light-reusable cotton options in terms of temperature distribution. CONCLUSION Carefully designed reusable blankets may provide a safe and environmentally friendly alternative to disposable forced air warming blankets, potentially reducing costs and environmental impact. Additional research examining infection control, durability through multiple laundering cycles and comprehensive life cycle analysis would further validate these promising findings.