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Fast track surgery for children with congenital pseudarthrosis of the tibia: A prospective interventional study
Yinzhi Yi1, Lin Dong2, Ni Zhang2
1Department of Pediatric Orthopedics, Hunan Children's Hospital, Pediatric Academy of University of South China, No.86, Ziyuan Road, Yuhua District, Changsha, Hunan, 410000, China; Hunan Provincial Key Laboratory of Pediatric Orthopedics, Hunan Children's Hospital, No.86, Ziyuan Road, Yuhua District, Changsha, Hunan, 410000, China.
Insights
Fast-track surgery combined with a clinical nursing pathway significantly improves outcomes for children with congenital pseudarthrosis of the tibia. This approach reduces complications and hospital stays, enhancing family satisfaction.
Area of Science:
- Pediatric Orthopedics
- Surgical Nursing
- Clinical Pathways
Background:
- Congenital pseudarthrosis of the tibia presents significant challenges in pediatric orthopedic care.
- Optimizing perioperative management is crucial for improving patient recovery and reducing complications.
Purpose of the Study:
- To evaluate the efficacy of fast-track surgery combined with a clinical nursing pathway for congenital pseudarthrosis of the tibia in children.
- To compare recovery metrics and complication rates between standard care and the enhanced pathway.
Main Methods:
- A comparative study involving 82 children with congenital pseudarthrosis of the tibia.
- Intervention group received fast-track surgery and an accelerated rehabilitation nursing pathway.
- Control group received routine clinical nursing pathway; data collected on recovery, complications, and satisfaction.
Main Results:
- The intervention group demonstrated significantly shorter durations for drainage tube and urinary catheter retention, and reduced hospital stay (P < 0.05).
- Postoperative complication incidence was markedly lower in the intervention group (5%) compared to the control group (21.42%) (P = 0.029).
- Family satisfaction was significantly higher in the intervention group (95.00%) versus the control group (80.95%).
Conclusions:
- Fast-track surgery nursing integrated with a clinical pathway is effective for treating congenital pseudarthrosis of the tibia in children.
- This combined approach leads to shorter hospitalizations, fewer complications, and increased family satisfaction.
- Implementing enhanced perioperative nursing strategies can optimize outcomes in pediatric orthopedic surgery.
Objective:
The purpose of this study was to explore the effect of fast-track surgery combined with a clinical nursing pathway on the recovery and complications of congenital pseudarthrosis of tibia.
Methods:
82 children with congenital pseudarthrosis of tibia admitted from January 2019 to December 2020 were selected as the study subjects. The control group received routine clinical nursing pathway while the intervention group received a fast-track surgery combined with a clinical nursing pathway. The fasting and water deprivation time were arranged according to the pre operation time, and the accelerated rehabilitation nursing models such as progressive diet management, multi-functional analgesia, and early sequential functional exercise were given after the operation. After collecting data on perioperative diet, postoperative recovery, postoperative complications, and family satisfaction from both groups of patients in a large hospital in China, a comparative analysis was conducted.
Results:
The retention time of negative pressure drainage tube, urinary catheter and hospital stay in the intervention group were shorter than those in the control group (P < 0.05); The incidence of complications in the intervention group (5%) was significantly lower than that in the control group (21.42%) (P = 0.029). The family satisfaction of the intervention group (95.00%) was higher than that of the control group (80.95%).
Conclusion:
Strengthening the concept of fast-track surgery nursing in the combined operation of congenital pseudarthrosis of tibia can shorten the hospitalization time of children, reduce the occurrence of postoperative complications and improve their family satisfaction.
