Cent Eur J Nurs Midw 2013, 4(1):537-545

The use of gum chewing in postoperative care of patients with abdominal surgery: developing an evidence-based clinical protocol - part I

Renáta Zeleníková1,*, Anthony Chao2, Gloria Enright2, Mary Rogers Schubert2, Kaitlin Shotsberger2, Cecelia Wise2, Elizabeth A. Schlenk2
1 University of Ostrava Faculty of Medicine Department of Nursing and Midwifery, Ostrava, Czech Republic
2 University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania

Aim: The aim of the paper was to search for evidence that the use of gum chewing in the postoperative care of patients who had undergone abdominal surgery decreases the risk of paralytic postoperative ileus by significantly reducing the time to first flatus and time to first bowel movement.

Methods: A literature review of selected meta-analyses and randomized control trials (RCT) was conducted to find the evidence that the use of gum chewing in the postoperative care of patients who had undergone abdominal surgery decreases the risk of paralytic postoperative ileus expressed as the time to first flatus and time to first bowel movement. The following databases were searched: OVID Medline®, CINAHL, and PubMed. The search focused on material published in English in peer-reviewed journals between the years 2002 and 2012. Weighted mean difference was the effect size abstracted from the meta-analyses of gum chewing on time to first flatus and time to first bowel movement. From the RCT, Cohen's d effect sizes were calculated to determine the strength of the gum chewing intervention on time to first flatus and time to first bowel movement. Forest plots were created to present the effect sizes from the RCT.

Results: Four randomized controlled trials and two meta-analyses were selected and critically appraised. All six studies concluded that gum chewing has a statistically significant and very large to medium effect on time to first flatus and time to first bowel movement. Based on the effect sizes, the conclusion was drawn that chewing gum during the postoperative period leads to a clinically significant reduction in time to passage of first flatus and time to first bowel movement.

Conclusion: Strong evidence supports the use of gum chewing in postoperative care of patients who have undergone abdominal surgery to reduce the risk of paralytic postoperative ileus.

Keywords: gum chewing, postoperative care, abdominal surgery, paralytic postoperative ileus, time to first flatus, time to first bowel movement

Published: March 30, 2013  Show citation

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Zeleníková R, Chao A, Enright G, Rogers Schubert M, Shotsberger K, Wise C, Schlenk EA. The use of gum chewing in postoperative care of patients with abdominal surgery: developing an evidence-based clinical protocol - part I. Ošetřovatelství a porodní asistence. 2013;4(1):537-545.
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