Application effect of anticipatory care in postoperative infection and complication management in children with acute appendicitis

Ning-Ning Xue; Xiang-Jing Li; Zhao-Ming Liu; Fei Tian; Li-Bo Wang; Jia-Huan Wang

doi:10.4240/wjgs.v17.i5.103141

Application effect of anticipatory care in postoperative infection and complication management in children with acute appendicitis

World J Gastrointest Surg. 2025 May 27;17(5):103141. doi: 10.4240/wjgs.v17.i5.103141.

Authors

Ning-Ning Xue¹, Xiang-Jing Li², Zhao-Ming Liu², Fei Tian³, Li-Bo Wang⁴, Jia-Huan Wang⁵

Affiliations

¹ Department of Pediatric Surgery, Shijiazhuang Maternal and Child Health Hospital, Shijiazhuang 050006, Hebei Province, China.
² Department of Plastic Surgery, Hebei Children's Hospital, Shijiazhuang 050000, Hebei Province, China.
³ Xingtai People's Hospital, Xingtai 054000, Hebei Province, China.
⁴ Pingxiang County People's Hospital, Xingtai 054500, Hebei Province, China.
⁵ Department of Pediatric Surgery, Shijiazhuang Maternal and Child Health Hospital, Shijiazhuang 050006, Hebei Province, China. wangjiahuan2014@163.com.

Abstract

Background: Acute appendicitis is common among pediatric patients, and postoperative infections and complications are significant factors that affect recovery. As a "forward-looking" nursing model, anticipatory care may reduce the incidence of postoperative wound infections and complications.

Aim: To explore the effects of anticipatory care on the management of postoperative infections and complications in pediatric patients diagnosed with acute appendicitis.

Methods: This prospective randomized controlled study included data from 78 pediatric patients who underwent acute appendicitis surgery at Shijiazhuang Sixth Hospital (Hebei Province, China) between February 2021 and March 2024. Patients were divided into two groups: The intervention and control groups (n = 39 each) were based on a random numbers table method. Both groups received routine postoperative nursing care, whereas the intervention group received additional anticipatory care. Statistical analyses were performed using independent sample t-tests, χ ² tests, analysis of variance, and rank-sum tests.

Results: Postoperative pain scores and hospital length of stay were significantly lower in the intervention group than those in the control group (P < 0.05 and P < 0.001, respectively). Postoperative wound infection and overall complication rates were significantly lower in the intervention group than those in the control group (5.13% vs 23.08%, P < 0.001; 15.38% vs 46.15%, P < 0.001, respectively). Furthermore, parental satisfaction scores were significantly higher in the intervention group than those in the control group (P < 0.05). Logistic regression identified high C-reactive protein level as a risk factor for postoperative infections and complications, whereas proactive (i.e. anticipatory) nursing intervention was a protective factor.

Conclusion: This study provided a scientific basis for the implementation of anticipatory care in the postoperative management of pediatric patients experiencing acute appendicitis.

Keywords: Acute appendicitis; Anticipatory care; Children; Complication; Postoperative infection.