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This study aims to compare an Enhanced Recovery After Surgery (ERAS) protocol with conventional postoperative care in adults undergoing emergency laparotomy for intestinal obstruction or intestinal perforation.
The main question this study aims to answer is:
• Does the ERAS protocol reduce surgical site infections compared with conventional care after emergency laparotomy?
Researchers will also compare other recovery outcomes between the two groups, including length of hospital stay, occurrence of paralytic ileus (temporary loss of bowel function), time to first bowel movement, and time to start taking fluids by mouth after surgery.
A total of 102 participants will be enrolled and randomly assigned to one of two groups. One group will receive postoperative care according to the ERAS protocol, while the other group will receive conventional postoperative care. All participants will undergo emergency laparotomy using standard surgical and anesthetic techniques.
Participants will:
The researchers hypothesize that patients managed with the ERAS protocol will have a lower frequency of surgical site infections and improved postoperative recovery compared with those receiving conventional care.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ERAS Protocol Group | Experimental | Participants undergoing emergency laparotomy will receive postoperative care according to the Enhanced Recovery After Surgery (ERAS) protocol. |
|
| Conventional Care Group | Active Comparator | Participants undergoing emergency laparotomy will receive standard postoperative care as routinely practiced in the surgical unit. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Enhanced Recovery After Surgery | Procedure | A standardized multimodal perioperative care pathway applied to patients undergoing emergency laparotomy. The protocol includes pre-defined components for preoperative optimization, intraoperative management, and postoperative care. Postoperative elements include early mobilization, early initiation of oral fluids and diet, optimized multimodal analgesia, early removal of tubes/drains when appropriate, and structured fluid management. |
| Measure | Description | Time Frame |
|---|---|---|
| Surgical Site Infection | Frequency of surgical site infection (superficial and deep) occurring within 30 days after emergency laparotomy will be assessed and compared between the Enhanced Recovery After Surgery (ERAS) group and the conventional care group. Surgical site infection will be defined and classified according to standard surgical infection criteria as specified in the study protocol | From enrollment within 30 days postoperatively |
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| Measure | Description | Time Frame |
|---|---|---|
| Hospital Stay | Length of hospital stay will be measured in days from the day of surgery until final disposition (discharge or death). | From surgery to discharge within 30 days |
| Paralytic Ileus | Incidence of postoperative paralytic ileus defined as presence of abdominal distension with absence of bowel sounds on clinical examination (auscultation for at least one minute). |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Muhammad I Seerat, FCPS | Recep tayyip Erdogan Hospital Muzaffargarh | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Recep Tayyip Erdogan Hospital Muzaffargarh | Muzaffargarh | Punjab Province | 34200 | Pakistan |
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|
| Conventional Postoperative Care | Procedure | Standard postoperative management routinely practiced in the surgical unit for patients undergoing emergency laparotomy. Care includes traditional postoperative monitoring, routine analgesia, delayed initiation of oral intake, standard mobilization practices, and conventional fluid and supportive management. |
|
| From surgery till hospital stay within 30 days postoperatively |
| Time to First Stool | Time (in days) from surgery to passage of first postoperative stool, indicating return of bowel function. | From surgery till hospital stay until discharge within 30 days postoperatively |
| Time to First Fluid Diet | Time (in days) from surgery to initiation and tolerance of first oral fluid intake postoperatively. | Postoperatively during hospital stay till discharge within 30 days postoperatively |
| ID | Term |
|---|---|
| D007415 | Intestinal Obstruction |
| D007416 | Intestinal Perforation |
| D013530 | Surgical Wound Infection |
| D011183 | Postoperative Complications |
| ID | Term |
|---|---|
| D007410 | Intestinal Diseases |
| D005767 | Gastrointestinal Diseases |
| D004066 | Digestive System Diseases |
| D014946 | Wound Infection |
| D007239 | Infections |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D000080482 | Enhanced Recovery After Surgery |
| ID | Term |
|---|---|
| D019990 | Perioperative Care |
| D013514 | Surgical Procedures, Operative |
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