Guarding the gut: early mobility after abdominal surgery

The postoperative period following abdominal surgery presents many challenges to patients and clinicians as recovery progresses and discharge from the intensive care unit approaches. Physiologic changes including the release of inflammatory mediators, increased fatigue and reduction in body mass, and a decline in pulmonary function occurring after abdominal surgery are often potentiated by bed rest and immobility. Evidence-based interventions have the potential to prevent pulmonary complications, wound instability, drain displacement, and orthostatic hypotension. Promoting early mobility is one example of an evidence-based strategy to improve patient outcomes. By understanding the specific needs of the abdominal surgery population, the clinician can safely and effectively implement a mobility plan. The purpose of this article was to briefly review the inflammatory effects associated with bed rest, critical illness, and surgery; review the literature related to mobility in the abdominal surgery patient; describe the effects of immobility on postoperative outcomes; discuss the safety concerns and barriers to mobilization; discuss strategies to overcome barriers; and provide suggestions for application in practice.