Conectar
Advances in surgical techniques and neoadjuvant care for rectal cancer have increased sphincter preservation, allowing restoration of bowel continuity through low anterior resection (LAR). However, up to 75% of patients experience low anterior resection syndrome (LARS), which is bowel dysfunction characterised by faecal incontinence, frequency, urgency and clustering of bowel movements, significantly impairing quality of life (QoL). Current management is largely empirical, using lifestyle or pharmacological strategies with variable success. Transanal irrigation (TAI) is a non-surgical intervention that allows controlled colonic washouts, improving symptom control. Evidence supporting TAI for LARS is limited by small sample sizes and is primarily observational, highlighting the need for a rigorous randomised controlled trial (RCT). This study aims to compare TAI with conventional LARS care on QoL, bowel function, faecal incontinence and satisfaction in adults with LARS following LAR.
This is a pragmatic, multicentre, crossover RCT conducted at eight academic hospitals across Quebec, Ontario and British Columbia, Canada. Eligible participants are adults (≥18 years) with an LARS score >20, at least 6 months post-LAR and without an ostomy or active colorectal complications. Participants will be randomised to receive either 3 months of daily TAI or conventional LARS care, followed by a 1 month washout and crossover to the alternate intervention. The TAI intervention includes an irrigation system, access to a web-based educational platform and virtual training with a research team member. Primary outcome is difference in global QoL between interventions, assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30. Secondary outcomes include bowel function (LARS score), faecal incontinence (Cleveland Clinic Faecal Incontinence Score) and satisfaction. Sample size (n=66, accounting for 10% attrition) was determined using Monte Carlo simulations to detect a 6-point difference in QoL with 85.8% power. Data will be analysed using linear mixed-effects models accounting for period, treatment and sequence effects. All study data will be collected via Research Electronic Data Capture and maintained in secure, password-protected systems; participant confidentiality will be ensured throughout. Safety monitoring will include training on proper TAI technique and reporting of adverse events.
The study has received ethics approval from each participating site. The trial adheres to the Canadian Tri-Council Policy Statement on the use of human participants in research. Findings will be disseminated through peer-reviewed journals, conference presentations and scientific meetings, with authorship following the International Committee of Journal Editors guidelines.
Medical device-related pressure injuries (MDRPIs) are a patient safety concern in acute and critical care settings. Registered nurses must implement preventive strategies, yet gaps remain in their knowledge, attitudes, and clinical practices related to MDRPI prevention. This study aimed to evaluate the effectiveness of a structured educational intervention in improving registered nurses' knowledge, attitudes, and practices related to MDRPI prevention. A quasi-experimental pre–post intervention study was conducted in a tertiary care hospital in Saudi Arabia, with 311 registered nurses participating. Data were collected using a questionnaire assessing knowledge, attitudes, and practices related to MDRPI prevention. Participants received a one-day structured educational program based on the knowledge, attitude, practice (KAP) framework and the evidence-based SKINCARE bundle. The educational intervention resulted in significant improvements. Mean scores increased from 14.17 (SD = 2.38) pre-intervention to 16.25 (SD = 1.97) post-intervention (t = −11.81, p < 0.001). The intervention demonstrated a moderate-to-large effect size (Cohen's d = 0.67), indicating meaningful improvement in nurses' preventive competencies. Structured educational programs can enhance registered nurses' knowledge and practices in MDRPI prevention. Integrating evidence-based training programs into routine hospital education may strengthen pressure injury prevention guidelines and improve patient safety outcomes.
A common complication of post-surgical procedures is surgical site infections (SSIs), and wound healing can be gravely affected by these SSIs. Perfumes are known for their use in personal hygiene; however, their role in surgical wound healing and SSIs has not been thoroughly studied. The present study explores the post-operative usage of perfumes in the context of SSIs and wound healing. This was a case–control study conducted in Hail City's Tertiary Care Hospital in Saudi Arabia for 9 months (April–December). The participants were adults undergoing clean elective plastic surgeries. Sixty-three patients were divided into case (n = 31) and control (n = 32) groups; the former used perfumes continuously post-operation and the latter refrained from them. All patients were observed and followed for three follow-up periods. Data on their demography, characteristics of wounds, patterns of perfume use (Arabic, Western and mixed), and infection outcomes were collected and statistically analysed using SPSS v22 at the significance level of < 0.05. In the present study, 49.21% of the total participants kept using perfume after their surgeries. The abdomen was the most common operative site in the control (16, 32%) and case (15, 48.38%) groups. The majority of the patients in the control (15, 46.87%) and case (21, 67.74%) groups had wound size > 15 cm (p > 0.05). Amongst 31 patients in the case group, most of the patients used mixed (Arabic and Western) perfumes (12, 38.7%, p = 0.65). The frequency of perfume application varied, as most participants (11, 35.48%) reported using perfume twice daily (p = 0.49). Meanwhile, 22 (71%) used 2–4 sprays per application (p < 0.05). During the first follow-up, SSIs were only reported amongst patients in a case group (2, 6.45%, p = 0.14). During the second follow-up, SSIs were observed in 3 (9.67%) and 2 (6.25%) patients in the case and control groups, respectively (p = 0.61). Meanwhile, in the third follow-up, the SSI pattern was changed, and patients in the control group developed SSIs (p = 0.10). Furthermore, a non-significant (p > 0.05) association was observed amongst the risk factors, including age, comorbidities, perfume types, operation type, wound site and wound size with infection rates. SSIs are not significantly associated with perfume usage after surgeries, even though the rates were higher amongst the non-perfume users. Future research can explore the biochemical analyses of different perfume types and their psychophysiological effects on wound healing.
FreshRSS 