Care package for postoperative constipation in orthopaedic surgery: A randomised controlled trial

Postoperative constipation is a common complication after orthopaedic surgery that adversely affects recovery and quality of life. Evidence on nurse-led, non-pharmacological interventions remains limited.

To evaluate the effectiveness of a nurse-led postoperative care package on constipation severity, time to first defecation, and stool consistency in orthopaedic surgery patients.

In this single-centre randomised controlled trial, conducted in an orthopaedic clinic of a state hospital between September 2022 and April 2023, patients were randomly assigned to the intervention (IG, n = 51) or control group (CG, n = 51). The CG received routine care, whereas the IG received a care package comprising a single 200 mL dose of warm water at postoperative hour 4, a 15-min abdominal massage twice daily on postoperative days 1-4, and a 30 g/day fibre diet. Data were collected using the Constipation Risk Assessment Scale, Visual Analogue Scale Questionnaire (VASQ), and Bristol Stool Form Scale (BSFS) preoperatively (T0) and on postoperative days 1-4 (T1-T4).

Demographic and clinical characteristics were similar between groups (p > 0.05). Time to first defecation was shorter in the IG than in the CG (18.73 ± 10.79 vs. 29.59 ± 17.47 h, p = 0.001). Constipation severity was significantly lower in the IG on postoperative days 2-4 (p < 0.001). Constipated stool (BSFS Types 1-2) was significantly less frequent in the IG from T1 onward (p < 0.05).

This nurse-led care package shortened time to first defecation and reduced constipation severity and the incidence of constipated stool in orthopaedic surgery patients. Its integration into clinical practice may improve patient outcomes and support evidence-based nursing care.

NCT06399133 (https://www.

gov/).