AccScience Publishing / JCTR / Online First / DOI: 10.36922/JCTR025010098
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REVIEW ARTICLE

Advances in thermal insulation nursing for hypothermia prevention in total hip arthroplasty: A review

Ping Ren1† ,  Peiqi He1† ,  Jiaying Xu1 ,  Wen Wang1 ,  Xin Men1 ,  Ting Tang1*
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1 Department of Anesthesiology and Operating Room, Changzhou Hospital of Traditional Chinese Medicine, Changzhou, Jiangsu, China
†These authors contributed equally to this work.
JCTR, 025010098 https://doi.org/10.36922/JCTR025010098
Received: 29 December 2025 | Revised: 25 February 2026 | Accepted: 30 March 2026 | Published online: 2 July 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Background: Population aging has driven rapid growth in total hip arthroplasty (THA), with over 60% of patients being elderly. However, perioperative hypothermia occurs in 30–60% of cases and is a key risk factor for poor prognosis. Despite this, clinical temperature management remains non-standardized. Aim: To systematically review advances in thermal insulation nursing for perioperative hypothermia in THA, providing evidence to support standardized temperature management pathways and optimize targeted thermal insulation strategies. The analyses cover the causes and impacts of hypothermia, thermal insulation nursing measures, evaluation indicators, and research hotspots. Results: Perioperative hypothermia in THA is mainly induced by anesthetic effects, body cavity exposure, cold fluid infusion, and elderly physiology. It increases the risks of intraoperative and postoperative bleeding and postoperative infection, prolongs anesthesia recovery and operative time, and worsens rehabilitation outcomes and patient satisfaction. The whole-process thermal insulation nursing—comprising preoperative risk assessment and prewarming, intraoperative active warming, and postoperative temperature management—effectively maintains core temperature (36–37.5 ℃) and significantly reduces the incidence of hypothermia and the risk of related complications. Evaluation indicators include temperature changes and complication rates, while contraindications and individualized application principles are clarified. Current research focuses on intelligent temperature control systems and hypothermia risk prediction models. However, challenges remain, including limited individualization for high-risk groups, non-standardized evaluation systems, and low implementation in primary care settings. Conclusion: Whole-process thermal insulation nursing is essential for enhanced recovery in THA, improving safety and outcomes, while reducing healthcare burden. Future efforts should prioritize individualized strategies for high-risk groups, standardized evaluation systems, and cost-effective, intelligent warming technologies to establish a comprehensive, widely applicable framework for perioperative temperature management. Relevance for patients: Thermal insulation nursing may improve rehabilitation outcomes in elderly patients undergoing THA.

Keywords
Hypothermia
Thermal insulation nursing
Total hip arthroplasty
Research progress
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
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