Study Title:

The Effect of Hot Water Pack Application to the Lumbar Region on Gastrointestinal Motility in Postoperative Abdominal Surgery Patients

Study Type:

Interventional (Randomized Controlled Trial)

Study Design:

Allocation: Randomized Intervention Model: Parallel Assignment Masking: Single-blind (Outcome Assessor) Primary Purpose: Supportive Care

Condition:

Postoperative Gastrointestinal Motility in Abdominal Surgery Patients

Interventions:

Experimental: Hot Water Pack Application Intervention: Application of a hot water pack (heated to 40-42°C) to the lumbar region for 20 minutes, three times a day, in the first 48 postoperative hours.

Purpose: To evaluate its effect on gastrointestinal motility and postoperative recovery.

Control: Routine Care Intervention: Standard postoperative care without hot water pack application.

Primary Outcome Measures:

Time to First Postoperative Gas (Hours) [Time Frame: Up to 72 hours]

Time to First Postoperative Stool (Hours) [Time Frame: Up to 72 hours] Time to Initiation of Oral Intake (Hours) [Time Frame: Up to 72 hours]

Secondary Outcome Measures:

Incidence of Postoperative Nausea and Vomiting (PONV) [Time Frame: Up to 72 hours] Severity of Abdominal Distension [Time Frame: Up to 72 hours]

Quality of Recovery-15 (QoR-15) Scale Score [Time Frame: Postoperative Days 1 and 3]

Gastrointestinal Symptom Rating Scale (GSRS) Score [Time Frame: Postoperative Days 1 and 3]

Eligibility Criteria:

Inclusion Criteria:

Abdominal surgery in the general surgery ward Age ≥ 18 years BMI between 18.50-24.99 kg/m² Able to communicate verbally Conscious, oriented, and willing to participate

Exclusion Criteria:

Previous gastrointestinal surgery Postoperative complications History of small bowel resection, ileostomy, or colostomy History of inflammatory bowel disease, emergency surgery, neoadjuvant therapy, appendectomy Chronic opioid use Chronic constipation (≤ 2 bowel movements per week) Abdominal radiotherapy ICU admission or postoperative bleeding

Estimated Enrollment:

80 participants (40 intervention, 40 control)

This study is a randomized controlled experimental design aimed at evaluating the effect of hot water pack application to the lumbar region on gastrointestinal motility (time to first postoperative gas, first stool, and initiation of oral intake) in patients undergoing abdominal surgery. The study will be conducted in the postoperative period.

Participants

The study will include patients who undergo abdominal surgery in the general surgery ward. Participants will be randomly assigned to one of two groups:

Intervention Group (Hot Water Pack Application) Control Group (Routine Care) Interventions

Intervention Group (Hot Water Pack Application):

Procedure: A hot water pack will be applied to the lumbar region for 20 minutes, three times a day during the first 48 postoperative hours. The hot water packs will be heated to a temperature of 40-42°C.

Purpose: To assess its effect on postoperative gastrointestinal motility (e.g., first gas, first stool, initiation of oral intake).

Control Group (Routine Care):

Procedure: Participants will receive standard postoperative care, which includes usual practices for abdominal surgery recovery without hot water pack application.

Inclusion Criteria:

18 years of age or older

Undergoing elective surgery

ASA I and III (American Society of Anesthesiologists physical status classification)

In the postoperative period, pulse, blood pressure, and body temperature within normal limits

Patients without previous gastrointestinal system surgery

Exclusion Criteria:

Previous gastrointestinal tract surgery

Complications in the postoperative period

History of small bowel resection and ileostomy or colostomy

History of inflammatory bowel diseases, emergency surgery, neoadjuvant therapy, appendectomy surgery

Chronic opioid use

Experiencing chronic constipation (≤ 2 bowel movements per week)

Receiving abdominal radiotherapy

Patients admitted to intensive care unit and patients with bleeding