386 MINT: Minimising Ileus through sham NuTrition
Mhairi Mactier, Arun Parajuli, Olivia Kemp, Tanyaradzwa Tom, Gary Nicholson- Surgery
Abstract
Background
Post-operative ileus is a common post-operative complication, leading to prolonged hospital stay and associated costs. Evidence suggests use of chewing gum after abdominal surgery is a safe, effective intervention to encourage gastrointestinal function and reduce post-operative ileus. The Enhanced Recovery After Surgery (ERAS) Society supports this as part of the multimodal post-operative recovery pathway.
Aim
To improve post-operative sham feeding in a tertiary colorectal unit.
Methods
Retrospective analysis of clinical notes and prescription charts was carried out between 17.4.2022-24.4.2022. Education was provided to all medical and nursing staff; posters were disseminated around relevant wards and stickers were placed at each computer base (accommodating for electronic prescribing). Prescription of chewing gum was also including in the day one post-operative checklist within the departmental ERAS booklet. Further data was collected between 3.10.2022-14.10.2022 to assess for improvement.
Results
Between 17.4.22-24.4.22, 11 patients underwent major abdominal surgery [n=11]. 0 patients were prescribed chewing gum.
Between 3.10.22-14.10.22, 17 patients underwent major abdominal surgery [n=17]. 16 were eligible for our study [n=16]. 19% patients had chewing gum prescribed [n=3]; none of which developed post-operative ileus, and all were discharged by post-operative day 9. 13% patients demonstrated evidence of post-operative ileus [n=2]; both remained inpatients at post-operative day 35.
Conclusion
Use of chewing gum is a cheap and effective way to reduce post-operative ileus and prolonged hospital stay. We wish to pursue this as routine practice in our tertiary unit. There is more work to do but this a fresh idea which deserves to be showcased.