Implementing enhanced recovery protocol to improve trauma laparotomy outcomes: A single-center pilot study

Area of Science:

• Trauma Surgery
• Surgical Critical Care
• Enhanced Recovery Protocols

Background:

• Enhanced Recovery Protocols (ERPs) optimize postoperative recovery and are standard in elective surgery.
• Application of ERPs in emergency general surgery is growing, but limited in trauma laparotomy.
• This study developed and evaluated an ERP for trauma laparotomy patients.

Purpose of the Study:

• To develop a tailored Enhanced Recovery Protocol for trauma laparotomy.
• To evaluate the impact of the protocol on patient outcomes.
• To assess feasibility and safety in a real-world clinical setting.

Main Methods:

• A multidisciplinary team created the Trauma Laparotomy Care Pathway (TLCP).
• A single-center pilot study compared TLCP patients to a historical cohort.
• Adherence to key postoperative components and patient outcomes were analyzed.

Main Results:

• The TLCP group (31 patients) had a significantly shorter hospital length of stay (4.0 vs 6.0 days, p=0.002).
• Adherence to TLCP components ranged from 54.5% to 67.7%.
• No significant differences in complications or 30-day readmissions were observed between groups.

Conclusions:

• The Trauma Laparotomy Care Pathway (TLCP) implementation reduced hospital length of stay in trauma laparotomy patients.
• The protocol appears safe, with no increase in complications or readmissions.
• ERPs may be beneficial for selected trauma laparotomy patients, warranting further investigation.