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World J Gastrointest Surg. Apr 27, 2026; 18(4): 116768 Published online Apr 27, 2026. doi: 10.4240/wjgs.v18.i4.116768
Impact of perioperative temperature management nursing quality on postoperative infectious complications in patients undergoing gastrointestinal surgery
Hai-Yan Jiang
Hai-Yan Jiang, Department of Hospital-Acquired Infection Control, Wuxi No. 8 People’s Hospital, Wuxi 214000, Jiangsu Province, China
Author contributions: Jiang HY was responsible for the research design, experimental implementation, data analysis, and writing of the manuscript.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of Wuxi No. 8 People’s Hospital (Approval No. 2025-Y-29).
Informed consent statement: All study participants and their legal guardians provided written informed consent before enrollment.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Received: January 13, 2026 Revised: February 5, 2026 Accepted: March 6, 2026 Published online: April 27, 2026 Processing time: 100 Days and 21.7 Hours
Abstract
BACKGROUND
Perioperative hypothermia is a common complication of gastrointestinal surgery and is associated with an increased risk of surgical site infections and other complications. However, the relationship between comprehensive temperature management quality, including monitoring, protocol adherence, timely intervention, and postoperative infection outcomes, remains insufficiently studied, particularly in relation to surgical approach and patient comorbidities.
AIM
To investigate the impact and underlying pathophysiological mechanisms of perioperative temperature management nursing quality on postoperative infectious complications in patients undergoing gastrointestinal surgery.
METHODS
A retrospective analysis was conducted on 45 patients who underwent elective gastrointestinal surgery at our institution between 2020 and 2025: Nine patients with postoperative infections within 30 days and 36 uninfected controls. A temperature-management compliance score was constructed and conditional logistic regression analysis was used to analyze the risk of postoperative infection. The effect modification was assessed in subgroups stratified by surgical approach and diabetes status. Differences in the microcirculatory, metabolic, and inflammatory mechanism-related indicators were compared between groups.
RESULTS
The case group had significantly lower intraoperative and immediate postoperative body temperatures, intraoperative active warming use, and temperature management compliance score and a longer hypothermia duration than the control (P < 0.05). The proportion of patients who underwent preoperative warming was not significantly different (P > 0.05). Multivariate conditional logistic regression analysis revealed that “lowest intraoperative body temperature” and “temperature management compliance scores” were independent risk factors for postoperative infections (P < 0.05). Surgical approach and diabetes status significantly affected the association between the lowest intraoperative body temperature and postoperative infection (P < 0.05). The case group had significantly higher intraoperative core temperature variability, core-to-skin temperature gradient, postoperative serum interleukin-6 levels, temperature management response delay time, and intraoperative fraction of inspired oxygen exposure index (P < 0.05), whereas intraoperative lactate clearance and immediate postoperative peripheral perfusion index were significantly lower (P < 0.05).
CONCLUSION
Perioperative hypothermia and inadequate nursing quality for temperature management are independent risk factors for postoperative infections following gastrointestinal surgery. Enhanced temperature monitoring and active warming via standardized individualized temperature management protocols may reduce the risk of postoperative infection, especially in patients undergoing open surgery and those with diabetes.
Core Tip: This 1:4 retrospective study of 45 patients who underwent elective gastrointestinal surgery identified the lowest intraoperative body temperature and temperature management compliance scores as independent risk factors for postoperative infectious complications. This association was significantly modified by the surgical approach (open vs laparoscopic) and the diabetes status. The underlying mechanisms involve impaired microcirculation (increased core-to-skin temperature gradient and decreased peripheral perfusion index), metabolic dysregulation (reduced lactate clearance), and increased systemic inflammation (elevated interleukin-6). Standardized individualized temperature management protocols are crucial, especially in open surgery and patients with diabetes.
