Emergency Laparotomy, Enhanced Recovery After Surgery (ERAS) Protocol, Intestinal Obstruction, Intestinal Perforation, Postoperative Recovery, Surgical Site Infection (SSI)
Conditions
Keywords
Enhanced Recovery After Surgery, Emergency Laparotomy, Surgical Site Infection, Postoperative complications, Intestinal Obstruction, Intestinal Perforation, Length of Hospital Stay, Postoperative Ileus
Brief summary
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: * Undergo emergency laparotomy for intestinal obstruction or intestinal perforation. * Receive either ERAS-based postoperative care or conventional postoperative care. * Be monitored during their hospital stay for recovery and postoperative complications. * Be assessed for bowel function recovery, ability to tolerate oral fluids, and length of hospital stay. * Be followed for 30 days after surgery to determine whether a surgical site infection develops. 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.
Interventions
PROCEDUREEnhanced Recovery After Surgery
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.
PROCEDUREConventional Postoperative Care
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.
Sponsors
Recep Tayyip Erdogan Hospital Pakistan - Muzaffargarh
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* acute intestinal obstruction or intestinal perforation * planned for emergency laparotomy
Exclusion criteria
* Pregnant women * Patients on chronic steroids * Chronic obstructive pulmonary disease * Malignant ulcers confirmed by histopathological examination * laparoscopic surgeries * Acute abdominal trauma * Patients who require postoperative intensive care unit (ICU) care
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Surgical Site Infection | From enrollment within 30 days postoperatively | 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 |
Countries
Pakistan
Contacts
STUDY_CHAIRMuhammad I Seerat, FCPS
Recep tayyip Erdogan Hospital Muzaffargarh
Outcome results
None listed