The determination of the effect of A constipation prevention care package on postoperative constipation severity in patients undergoing orthopedic surgery

Constipation is a common problem in patients undergoing orthopedic surgery; however, there is a lack of literature on a care package specifically designed to prevent constipation. This study aimed to determine the effectiveness of a three-pronged care package, including warm water intake, abdominal massage, and a high-fiber diet, in preventing constipation and reducing its severity during the early postoperative period. Ethical approval was obtained before commencing the research (2022/051). The study was conducted between September 15, 2022, and April 30, 2023, at a hospital in Gaziantep. After providing information about the research, patients were randomly assigned to two groups: the study group (n=51) and the control group (n=51). Patients in the study group received the care package, consisting of warm water intake of 200 ml at the fourth hour after surgery, abdominal massage twice daily starting from the first day after surgery, and a high-fiber diet containing 30 grams of fiber daily. Patients in the control group received routine clinical practices. Data for the study were collected using the "Demographic Information Form," "Constipation Risk Assessment Scale," "Visual Analog Scale," and "Bristol Stool Form Scale." Constipation severity and stool consistency were evaluated by applying these scales on patients at five time points: one day before surgery (T0), one day after surgery (T1), two days after surgery (T2), three days after surgery (T3), and four days after surgery (T4). Data were analyzed using SPSS 20.0 (IBM, Canada), and a p-value less than 0.05 was considered statistically significant. The study and control groups were similar in terms of demographic and clinical characteristics (p>0.05). At the T0 assessment, constipation risk, severity, and stool consistency were similar in both study and control groups (p>0.05). At the T1 assessment, constipation severity was similar between the study and control groups (p>0.05). However, at the T2, T3, and T4 assessments, there was a statistically significant difference in constipation severity and stool consistency scores between the study and control groups (p<0.05). Patients in the study group had a mean time of 18.73±10.79 hours for the first defecation after surgery, while the control group had a mean time of 29.59±17.47 hours, and this difference was statistically significant (p=0.001). Constipation severity and stool consistency scores were lower in the study group and higher in the control group. These findings indicate that the constipation prevention care package is effective in patients undergoing orthopedic surgery.