实用医学杂志 ›› 2025, Vol. 41 ›› Issue (16): 2515-2520.doi: 10.3969/j.issn.1006-5725.2025.16.011

• 临床研究 • 上一篇    

加速康复外科围术期管理理念下术后早期沐浴的可行性

刘星宇1,2,江志伟2,李峻2,管俊杰2,龚冠闻2()   

  1. 1.南京中医药大学第一临床医学院 (江苏 南京 210023 )
    2.南京中医药大学附属医院普外科 (江苏 南京 210029 )
  • 收稿日期:2025-04-15 出版日期:2025-08-25 发布日期:2025-08-28
  • 通讯作者: 龚冠闻 E-mail:love_ggw2@163.com
  • 基金资助:
    中国医药教育协会重大课题项目(2022KTZ005);国家中医药管理局名医验方评价与转化重点研究室资助项目(608);江苏省中医药管理局领军人才项目(SLJ0311);江苏省卫生健康委重点学科(ZDXK202251)

Feasibility of early postoperative bathing under the concept of perioperative management in enhanced recovery after surgery

Xingyu LIU1,2,Zhiwei JIANG2,Jun LI2,Junjie GUNA2,Guanwen GONG2()   

  1. 1.The First Clinical Medical College of Nanjing University of Chinese Medicine,Nanjing 210023,Jiangsu,China
    2.Department of General Surgery,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu,China
  • Received:2025-04-15 Online:2025-08-25 Published:2025-08-28
  • Contact: Guanwen GONG E-mail:love_ggw2@163.com

摘要:

目的 探究基于加速康复外科围术期管理理念下术后患者早期进行沐浴的可行性 方法 选取2024年12月至2025年5月由普外科收治行腹腔镜下阑尾或胆囊切除术的患者156例。根据术后24 h以后选择的沐浴方式,将患者随机分为早期沐浴暴露组、早期沐浴贴膜组及对照组3组。早期沐浴暴露组患者术后24 h以上即进行裸露切口的沐浴,早期沐浴贴膜组患者切口覆盖无菌防水贴膜后沐浴,对照组患者则术后常规禁浴,待切口拆线后再延迟至少3 d进行沐浴活动,记录并分析3组患者基本情况、切口感染发生率、术后并发症、术后住院天数及随访情况等资料。 结果 最终早期沐浴暴露组纳入患者54例,早期沐浴贴膜组纳入52例,对照组50例。3组患者在性别、年龄、原发疾病、基础疾病、体质量指数(BMI)、手术方式、手术时长、手术切口分类等临床一般资料方面比较差异均无统计学意义(均P > 0.05)。术后统计各组术后沐浴时间、切口感染发生率、并发症情况及术后住院天数等对比差异亦无统计学意义(均P > 0.05),而在住院期间的满意度方面,统计发现早期沐浴的两组患者显著高于对照组,差异有统计学意义(均P < 0.05)。 结论 相比传统的术后禁浴原则,早期沐浴并不会增加切口的感染率,且能够提高患者住院期间满意度,拓展了加速康复外科术后早期活动的内容,值得临床推广。

关键词: 术后早期沐浴, 手术部位感染, 加速康复外科, 围术期管理, 住院期间满意度

Abstract:

Objective To evaluate the feasibility of early postoperative bathing within the framework of Enhanced recovery after surgery (ERAS) perioperative management. Methods A total of 156 patients who underwent laparoscopic appendectomy or cholecystectomy in the Department of General Surgery between December 2024 and May 2025 were included in the study. Based on the postoperative bathing protocol selected 24 hours after surgery, patients were randomly assigned to one of three groups: the early bathing-exposed group, the early bathing-covered group, or the control group. In the early bathing-exposed group, patients were permitted to bathe with the surgical incision uncovered 24 hours postoperatively. In the early bathing-covered group, sterile, waterproof dressings were applied to the incision site during bathing to maintain aseptic conditions. The control group followed conventional postoperative care guidelines, which restricted bathing until at least three days after suture removal. The outcomes, including the incidence of surgical site infection, postoperative complications, length of hospital stay, and follow-up data, were systematically recorded and analyzed across all three groups. Results Finally, 54 patients were included in the early bathing-exposed group, 52 in the early bathing-covered group, and 50 in the control group. No statistically significant differences were observed among the three groups in terms of baseline clinical characteristics, including gender, age, primary disease, comorbidities, body mass index (BMI), surgical procedure, operative duration, or incision classification (all P > 0.05). Similarly, postoperative comparisons of time to first bathing, incisional infection rates, complication incidence, and length of hospital stay showed no significant intergroup differences (all P > 0.05). However, with respect to patient satisfaction during hospitalization, both early bathing groups reported significantly higher satisfaction scores compared to the control group, and these differences were statistically significant (all P < 0.05). Conclusions Compared with the conventional principle of postoperative water restriction, early bathing does not increase the incidence of surgical site infection and contributes to improved patient satisfaction during hospitalization. This approach broadens the scope of early postoperative interventions within the ERAS protocol and warrants further clinical implementation.

Key words: early postoperative bathing, surgical site infection, enhanced recovery after surgery, perioperative management, hospitalization satisfaction

中图分类号: