Effect of carboxymethyl chitosan/amorphous calcium phosphate complexes on postoperative infection in patients with spinal cord injury

Abstract

To explore the postoperative rehabilitative effect of continuity of nursing care and nanomaterial oral nursing intervention in patients with spinal cord injuries (SCI). Eighty patients with SCIs from spinal fractures, who were treated in our hospital from January 2019 to August 2021, were randomly divided into control and nursing groups ( n = 40 each). The control group patients received conventional nursing care, while the nursing group received continuity of care (regular timely follow-ups, guided diet and medication plans, and countermeasures for complications) and oral care using nanoscale carboxymethyl chitosan/amorphous calcium phosphate (CMC/ACP) composite particles. Perioperative indicators, complication rates, oral and dental scores, and satisfaction with nursing care were compared postoperatively between the two groups. Control group patients had significantly higher out of bed activity time, hospitalization time, hospitalization expenses, and incidence of complications than those in the nursing group. Additionally, they had higher serum levels of inflammatory markers (TGF- β 1, IL-6, and TNF- α ) than the nursing group ( P <0.05). On the other hand, the nursing group had higher oral scores and significantly lower buccal plaque index than the control group. Lastly, satisfaction rates were higher in the nursing group (97.5%) than in the control group. Continuity of care in SCI patients is an effective nursing approach to minimize the incidence of postoperative debilitating infections and related complications, and facilitate recovery. Additional oral care using nano-CMC/ACP composites can improve oral health in these patients.