Purpose: Surgical site infections (SSI) result in prolonged hospital stays, increased healthcare costs, and adverse patient outcomes. The use of WHCI in open abdominal surgery is a novel technique that claims to reduce SSI rates by minimising peritoneal desiccation and preventing intra-operative normothermia. We aim to investigate the potential benefits of WHCI in open surgery including SSI rates, mean core temperature, and length of stay. Methodology: A systematic review and meta-analysis was carried out in line with PRISMA guidelines. Cochrane risk-of-bias tool (RoB-2) was used to assess study quality. Log odds ratio (OR) and standard error (SE) were calculated for categorical variables and standardised mean differences (SMD) and standard error (SE) were calculated for continuous variables. Statistical heterogeneity was assessed with the use of Cochrane Q test and I² statistics. Forest plots were generated to visualise data. Results: Six randomised control trials met inclusion and exclusion criteria (n=287). The meta-analysis suggests potential reduction in SSI rates (OR = 0.38, p=0.12) and an increase in mean core temperature with WHCI (SMD = 1.13, p=0.06), though statistical significance is not reached. There was no significant difference in length of stay (SMD = 0.07, p=0.45). Conclusion: This is the first systematic review and meta-analysis to investigate outcomes of WHCI in open surgery. Results suggest potential benefits in reducing SSI rates and increasing mean core temperature, however lack statistical significance. Currently there is not enough evidence to suggest benefit of WHCI in open surgery and larger high quality randomised controlled trials are required.