A thermal pad for controlling a patients temperature includes first and second chambers defined between interior and exterior layers. The first chamber circulates a temperature controlled fluid from a first inlet to a first outlet. The second chamber is in fluid communication with a port and a plurality of holes defined in the interior layer. Pressurized gas supplied to the second chamber is vented onto the patient to control the microclimate between the patients skin and the thermal pad. An additional third chamber is provided in some embodiments that urges the thermal pad into contact with the patient when subjected to negative gauge pressure. In other embodiments, a negative gauge pressure chamber is allowed to partially inflate in order to urge the thermal pad into contact with the patient.
