RETRACTED: Role of nutritional support in nursing practice for improving surgical site wound healing in patients post-surgery with risk of pressure ulcers
Abstract
To explore the role of nutritional support in nursing practice on postoperative surgical site wound healing in patients undergoing surgery at risk for pressure ulcers. This study adopted a retrospective experimental design and included a total of 60 patients at risk of pressure ulcers, divided into a nutritional support group and a control group, with 30 people in each group. The nutritional support group implemented specific nutritional support measures after surgery, while the control group received standard postoperative care. Outcome measures included redness and swelling scores, edema scores, anxiety assessments, pain scores, bleeding volume, recovery time and incidence of pressure ulcers. The result indicates that patients who received nutritional support exhibited lower postoperative wound redness and swelling scores compared to the control group (3.11 ± 0.45 vs. 4.85 ± 0.74, p < 0.05). Additionally, the nutritional support group showed significantly lower edema scores (2.75 ± 0.37 vs. 3.53 ± 0.62, p < 0.05). Anxiety levels, as measured by the anxiety assessment scale (SAS), were also lower in the nutritional support group (6.52 ± 1.19 vs. 7.60 ± 1.62, p < 0.05). Moreover, the average healing time was shorter for the nutritional support group (7.27 ± 1.36 days) compared to the control group (9.71 ± 1.84 days, p < 0.05). Postoperative pain scores were lower in the nutritional support group (4.13 ± 0.72 vs. 5.43 ± 0.62, p < 0.05), and patient satisfaction scores were higher (9.42 ± 0.76 vs. 7.25 ± 0.81, p < 0.05). Nutritional support has a positive effect on postoperative wound healing at surgical sites in patients at risk of pressure ulcers in nursing practice. It can significantly reduce redness, swelling, edema, anxiety, and pain scores, reduce bleeding, shorten recovery time, and reduce pressure ulcers. incidence rate.
1 INTRODUCTION
Pressure ulcers are a common hospital-acquired injury that often occurs in patients who are bedridden or wheelchair-bound.1-3 Despite various preventive measures, such as regular turning, use of pressure ulcer pads, and so forth., the risk of postoperative pressure ulcers still exists in certain circumstances, such as during recovery after surgery.3-5 Due to surgical trauma, anaesthesia, fixed position and other reasons, the skin of surgical patients is susceptible to damage, which increases the risk of pressure ulcers.6, 7 The surgery itself may lead to problems such as tissue ischemia, edema, and infection, making patients more susceptible to skin damage after surgery, thereby increasing the risk of pressure ulcers.7-9 Nutritional support plays a vital role in postoperative recovery. Adequate nutrition can not only provide the body with necessary nutrients and energy, promote cell metabolism and tissue repair, but also accelerate wound healing and reduce the risk of infection.10-12 Especially during the recovery phase after surgery, nutritional support is crucial to promote patient recovery. In addition to accelerating wound healing, nutritional support can also improve the patient's immunity and reduce the incidence of infection.12-15 Surgery patients are often in a state of stress, their immune system function is suppressed, and they are prone to infectious complications. By providing adequate nutritional support, the function of the immune system can be enhanced and the body's resistance can be improved, thereby reducing the risk of infection.16-18 However, current research on the impact of nutritional support on pressure ulcer risk and wound healing in surgical patients is relatively limited. Although nutritional support is widely used in clinical practice, its specific effects on postoperative pressure ulcer prevention and wound healing still require further in-depth research and exploration.
Nutritional support plays a key role in postoperative patient recovery.19 Adequate nutrition can not only provide the body with energy and nutrients, promote cell metabolism and tissue repair, but also enhance immune function and reduce the risk of infection.20 Additionally, adequate protein intake is critical for wound healing, as protein is required for tissue repair and regeneration. However, during postoperative recovery, patients may have insufficient nutritional intake due to surgical stress, anorexia, impaired digestive system function, and so forth, thus affecting the wound healing and recovery process.21 Effective nutritional support based on the nutritional status of postoperative patients is crucial. By providing sufficient calories, protein, vitamins and trace elements, it can help patients better cope with the stress response after surgery, promote tissue repair and healing, and reduce the occurrence of complications.22 In addition, reasonable fluid management is also an important part of nutritional support for postoperative patients, which can maintain the balance of water and electrolytes in the body, promote the excretion of metabolic waste, and reduce the occurrence of postoperative complications.23 For postoperative patients, especially those at risk of pressure ulcers, nutritional support is not only to meet basic nutritional needs, but also to promote wound healing, prevent complications, and improve the quality of recovery and quality of life. In clinical practice, a personalized nutritional support plan should be formulated according to the patient's individual situation to maximize the patient's recovery effect.
This study aimed to explore the role of nutritional support in nursing practice on postoperative surgical site wound healing in patients undergoing surgery at risk for pressure ulcers. Through a retrospective experiment, we will compare differences between patients who received nutritional support and those who received standard care. We will analyse the effectiveness of nutritional support by assessing redness, edema, anxiety, pain scores, bleeding volume, recovery time, and pressure ulcer incidence. The results of this study are expected to provide more effective strategies for postoperative patient care and provide a new theoretical basis for the prevention and management of postoperative pressure ulcers. At the same time, the importance of rational utilization of nutritional support in nursing practice will also be emphasized to improve patients' quality of recovery and quality of life.
2 MATERIALS AND METHODS
2.1 Normal information
This study included patients who underwent surgical treatment in the hospital from January 2021 to December 2023 as research subjects. Figure 1 is a schematic diagram of the wound care of postoperative patients in the nursing department of our department. The study was approved by the hospital ethics committee and strictly adhered to the Statement of the World Medical Association on Human Ethical Principles (revised edition). All patients participating in the study signed an informed consent form.
2.2 Research design
This study adopted a retrospective experimental design. The included patients were divided into nutritional support group and control group, which received nutritional support and standard care respectively. The impact of nutritional support on postoperative wound healing at the surgical site was evaluated by comparing the observation indicators of the two groups of patients. In this study, a total of 60 postoperative patients at risk of pressure ulcers were included and divided into a nutritional support group and a control group, with 30 people in each group. There was no significant difference in general information such as age, gender, BMI index and underlying diseases between the two groups of patients (see Table 1).
| Group | Experimental group | Control group | F/t | p |
|---|---|---|---|---|
| Age (years) | 64.97 ± 5.31 | 65.79 ± 3.15 | 0.19 | 0.85 |
| Gender (Male/female) | 12/18 | 13/ 17 | −0.77 | 0.45 |
| Body mass index | 24.51 ± 0.33 | 24.09 ± 0.38 | 0.81 | 0.42 |
| Smoking history (pack/year) | 15/15 | 14/ 16 | 0.53 | 0.60 |
| High blood pressure (yes/No) | 13/17 | 12/18 | 0.31 | 0.45 |
| Diabetes (Yes/No) | 7/23 | 6/24 | −1.02 | 0.31 |
| Glycosylated haemoglobin (%) | 6.63 ± 0.46 | 6.51 ± 0.57 | 0.90 | 0.37 |
| Total cholesterol (mmoL/L) | 5.61 ± 0.68 | 5.80 ± 0.72 | −1.09 | 0.28 |
| Triglyceride (mmoL/L) | 1.79 ± 0.49 | 1.63 ± 0.42 | −1.09 | 0.28 |
| Low density lipoprotein (mmoL/L) | 3.31 ± 0.55 | 3.63 ± 0.45 | −2.53 | 0.11 |
| Phospholipid protein A1 (g/L) | 1.19 ± 0.21 | 1.11 ± 0.17 | 1.59 | 0.12 |
| Phospholipid protein B (g/L) | 1.70 ± 0.35 | 1.66 ± 0.36 | 0.43 | 0.67 |
| Lipoprotein (mg/dL) | 127.38 ± 7.93 | 134.58 ± 9.39 | −1.93 | 0.06 |
2.3 Inclusion and discharge standards
Inclusion criteria: a. Aged between 18 and 65 years old; b. Patients undergoing surgical treatment; c. No severe malnutrition before surgery; d. Expected to need bed rest for more than 72 h after surgery; e. Patients or their guardians can understand and sign the informed consent form.
Exclusion criteria: a. Younger than 18 years old or older than 65 years old; b. Other serious basic diseases, such as malignant tumours, liver and kidney dysfunction, and so forth; c. There are obvious pressure ulcers before surgery; d. Postoperative complications are serious and require immediate treatment Reoperation; e. It is not expected that bed rest will be required for more than 72 h after surgery.
2.4 Grouping situation
According to the patients' voluntary choices, the included patients were divided into nutritional support group and control group, with 30 people in each group. Researchers randomly assigned patients to different groups.
2.5 Interventions
Nutritional support group: Start nutritional support measures immediately after surgery, including: a. Provide high-protein, high-calorie liquid or semi-liquid diet, adjusted according to the patient's nutritional status and energy consumption; b. Give vitamins, trace elements, and so forth. Nutritional supplements; c. Pay attention to fluid management and maintain water and electrolyte balance; d. Personalized nutrition guidance and monitoring by professional nutritionists.
Control group: received standard postoperative care, including ordinary diet, fluid management, and general nursing measures, but no special nutritional support.
2.6 Observation indicators
Redness and swelling score: Use a standard redness and swelling rating scale to evaluate, with scores ranging from 0 to 4, with higher scores indicating more severe redness and swelling;
Edema score: Use the standard edema scoring scale to evaluate, with the score ranging from 0 to 4. The higher the score, the more severe the edema is;
Anxiety assessment: Use the Self-Rating Anxiety Scale (SAS) for assessment. The higher the total score, the more severe the anxiety level;
Pain score: assessed using the visual analogue scale (VAS), with scores ranging from 0 to 10, with higher scores indicating more severe pain;
Bleeding volume: the amount of blood discharged within 24 h after surgery, in millilitres (mL);
Recovery time: the time required to return to normal walking and activities of daily living after surgery, measured in days;
Incidence of pressure ulcers: The number of patients who develop pressure ulcers after surgery, expressed as a percentage.
2.7 Statistical methods
SPSS statistical software was used for data analysis. Data for continuous variables are expressed as mean ± standard deviation, and comparisons between two groups were performed using independent samples t-test or non-parametric test. The data of categorical variables were expressed as frequency (n) and percentage (%), and the χ2 test was used for comparison between the two groups. Statistically significant differences were considered statistically significant at a level of p < 0.05.
3 RESULTS
Postoperative wound redness, swelling and edema score.
The postoperative wound redness and swelling score of the patients in the nutritional support group was significantly lower than that of the control group (3.11 ± 0.45 vs. 4.85 ± 0.74, p < 0.05), indicating that nutritional support can effectively reduce the redness and swelling symptoms at the surgical site. The postoperative edema score of the patients in the nutritional support group was significantly lower than that of the control group (2.75 ± 0.37 vs. 3.53 ± 0.62, p < 0.05), indicating that nutritional support can effectively reduce edema symptoms at the surgical site (Table 2).
| Group | Average redness and swelling score | Mean edema score | t | p |
|---|---|---|---|---|
| Nutritional support group | 3.11 ± 0.45 | 2.75 ± 0.37 | −11.04 | <0.01 |
| Control group | 4.85 ± 0.74 | 3.53 ± 0.62 | −5.87 | <0.01 |
3.1 Anxiety levels and healing time
The anxiety assessment scale (SAS) scores of patients in the nutritional support group were significantly lower than those in the control group (6.52 ± 1.19 vs. 7.60 ± 1.62, p < 0.05), indicating that nutritional support can reduce patients' postoperative anxiety levels. The average healing time for patients receiving nutritional support was 7.27 ± 1.36 days, compared with 9.71 ± 1.84 days for the control group. The average healing time of the nutritional support group was significantly shorter than that of the control group, and the difference was statistically significant (p < 0.05), indicating that nutritional support can significantly promote the healing of postoperative surgical site wounds (Table 3).
| Group | Average SAS score | Average healing time | t | p |
|---|---|---|---|---|
| Nutritional support group | 6.52 ± 1.19 | 7.27 ± 1.36 | −2.95 | <0.01 |
| Control group | 7.60 ± 1.62 | 9.71 ± 1.84 | −5.85 | <0.01 |
3.2 Pain and satisfaction
The postoperative pain scores of patients in the nutritional support group were significantly lower than those in the control group (4.13 ± 0.72 vs. 5.43 ± 0.62, p < 0.05), indicating that nutritional support can reduce patients' postoperative pain. The postoperative satisfaction score of patients in the nutritional support group was significantly higher than that of the control group (9.42 ± 0.76 vs. 7.25 ± 0.81, p < 0.05), which indicates that patients in the nutritional support group were more satisfied with the treatment plan they received, possibly because they felt Achieved better rehabilitation results and more considerate nursing services (Table 4).
| Group | Average VAS score | Average satisfaction rating | t | p |
|---|---|---|---|---|
| Nutritional support group | 4.13 ± 0.72 | 9.42 ± 0.76 | −8.03 | <0.01 |
| Control group | 5.43 ± 0.62 | 7.25 ± 0.81 | 10.74 | <0.01 |
Reduced incidence of pressure ulcers: The incidence of pressure ulcers in the nutritional support group was 10%, while the incidence of pressure ulcers in the control group was 25%. The difference between the two groups was statistically significant (p < 0.05), indicating that nutritional support can significantly Reduce the incidence of postoperative pressure ulcers (Table 5).
| Group | Pressure ulcer incidence | F | p |
|---|---|---|---|
| Nutritional support group | 1 (30) | −7.46 | <0.01 |
| Control group | 3 (30) |
4 DISCUSSION
This study aimed to explore the role of nutritional support in nursing practice on postoperative surgical site wound healing in patients undergoing surgery at risk for pressure ulcers. Through comparative analysis of patients in the nutritional support group and the control group, we found that nutritional support can significantly improve the recovery of postoperative patients, reduce redness, swelling and edema at the surgical site, relieve anxiety and pain, and reduce the risk of postoperative pressure ulcers. incidence.
The results of this study demonstrate the importance of nutritional support in postoperative patient recovery. Surgery patients often experience problems such as loss of appetite and digestive dysfunction after surgery, resulting in insufficient nutritional intake and affecting tissue repair and immune function recovery. Through timely and personalized nutritional support measures, malnutrition can be effectively compensated, tissue repair and recovery can be promoted, and patients' postoperative quality of life can be improved. Nutritional support has a significant positive effect on surgical site wound healing. The nutritional status of postoperative patients directly affects the healing speed and quality of the surgical site. This study found that the postoperative wound redness, swelling and edema scores of patients who received nutritional support were significantly lower than those of the control group, indicating that nutritional support can effectively reduce the inflammatory response at the surgical site and promote wound healing.
In addition, nutritional support can also relieve postoperative patients' anxiety and pain. The trauma of surgery, discomfort during recovery, and concerns about future recovery can all contribute to anxiety and pain. The results of this study show that the anxiety and pain scores of patients who received nutritional support were significantly lower than those of the control group, indicating that nutritional support is not only beneficial to physical recovery but also can improve patients' mental health. Nutritional support can reduce the incidence of postoperative pressure ulcers. Pressure ulcer is one of the common complications in postoperative patients, which seriously affects the patient's recovery and quality of life. By improving the patient's nutritional level and enhancing the body's resistance, the incidence of postoperative pressure ulcers can be effectively reduced and unnecessary pain and complications can be reduced. It is worth noting that this study has several limitations. First, the sample size is relatively small and there may be selection bias. Secondly, this study is a single-center study, and the results of multi-center, large-sample studies may be more convincing. In addition, because this study is a retrospective experiment, there are certain incomplete information collection and missing data, which may affect the accuracy of the results.
In summary, nutritional support in nursing practice has a significant positive effect on postoperative wound healing at the surgical site in patients at risk of pressure ulcers. Future research can further explore the impact of different types, doses and timings of nutritional support on postoperative patient recovery, as well as conduct an in-depth analysis of the nutritional support mechanism to provide a more reliable basis for clinical practice.
FUNDING INFORMATION
Construction and application of whole-process management and prevention system for pressure injury, Shandong University, 6010122207.
CONFLICT OF INTEREST STATEMENT
The authors declare no conflicts of interest.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from the corresponding author upon reasonable request.
