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Commentary on: The impact of perioperative hypothermia on plastic surgery outcomes: a multivariate logistic regression of 1062 cases.

Constantine et al1 chose the interesting approach of studying not only the important subject of perioperative hypothermia but also the impact of perioperative hypothermia on outcomes by using a large 4-year database from an academic medical center. However, the retrospective nature of their study led to severe limitations with regard to the conclusions that can be drawn because cases cannot be compared when a well-defined protocol is missing.

For example, the authors mention the inclusion of “intraoperative temperature” in the database and subsequent analysis, as well as the exclusion of all cases for which this information was not present. Unfortunately, we do not know whether this means core temperature as measured using an esophageal or a tympanic membrane probe2 or skin or rectal temperature, which cannot be considered to be core temperature.3

Analyzing the charts of 1801 procedures is hard work, for which the authors must be congratulated. Unfortunately, we do not know what the inclusion criteria were for this number of “complex plastic …