bowel sound
chewing gum
post surgery

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Amanda, W. M., Purba, C. I. H., & Mirwanti, R. (2019). DIFFERENCE OF BOWEL SOUND RETURN TIME AMONG POST-LAPARATOMY SURGERY PATIENTS AFTER CHEWING GUM. Belitung Nursing Journal, 5(5), 204–211. https://doi.org/10.33546/bnj.826
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Accepted for publication: 2019-08-23
Peer reviewed: Yes

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Background: A surgical procedure using general anaesthesia in laparotomy surgery results in reduced bowel sound. A large number of patients who experience a delay in returning bowel sound after laparotomy surgery become the reason to give proper intervention in order to increase bowel sound return time. One of the non-pharmacological interventions that can be used is chewing gum.

Objective: The purpose of this study is to identify the difference of bowel sound return time between groups of intervention and control after being given chewing gum intervention among post-laparotomy surgery patients.

Methods: This quasi-experimental study used post-test only control group design. Thirty respondents were selected by purposive sampling technique. Data were collected through observation by calculating the bowel sound return time among post laparotomy surgery patients in the intervention group (n=15) and control group (n=15), and were analyzed using the Mann Whitney test.  The intervention group was asked to chew the gum once for 30 minutes, and bowel sound was measured every 30 minutes for 120 minutes.

Results: The results showed that bowel sound return time in the intervention group was 90 minutes and the control group was 150 minutes, and p-value was 0.005.

Conclusion: There was a difference in the return time of bowel sound between the intervention and control groups. Therefore, the intervention of chewing gum could become one of the non- pharmacological interventions that can be considered in increasing the bowel sound return time among post-laparotomy surgery patients.



Copyright (c) 2019 Warisya Miftah Amanda, Chandra Isabella H.P, Ristina Mirwanti

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Andersson, T., Bjerså, K., Falk, K., & Olsén, M. F. (2015). Effects of chewing gum against postoperative ileus after pancreaticoduodenectomy–a randomized controlled trial. BMC Research Notes, 8(1), 37. https://doi.org/10.1186/ s13104-015-0996-0

Atkinson, C., Penfold, C. M., Ness, A. R., Longman, R. J., Thomas, S. J., Hollingworth, W., . . . Lewis, S. J. (2016). Randomized clinical trial of postoperative chewing gum versus standard care after colorectal resection. British Journal of Surgery, 103(8), 962-970. https://doi.org /10.1002/bjs.10194

Barletta, J. F., & Senagore, A. J. (2014). Reducing the burden of postoperative ileus: evaluating and implementing an evidence-based strategy. World Journal of Surgery, 38(8), 1966-1977. https://doi.org/10.1007/s00268-014-2506-2

Bashankaev, B., Khaikin, M., & Wexner, S. D. (2009). Postoperative ileus an algorithm for prevention and management. Retrieved from www.pharmacyprac ticenews.com/ViewArticle.aspx?d_id=63&a_id=14217

Bastiana, A. R. (2016). Waktu pemulihan bising usus pada pasien post operasi dengan anastesi umum di ruang anggrek RSUD Sumedang [Time of colon noise recovery in post surgery patients with general anesthesia in the anggrek room of Sumedang Hospital]. (Thesis). Bandung: Fakultas Keperawatan Universitas Padjadjaran.

Berghmans, T. M. P., Hulsewé, K. W. E., Buurman, W. A., & Luyer, M. D. P. (2012). Stimulation of the autonomic nervous system in colorectal surgery: A study protocol for a randomized controlled trial. Trials, 13(1), 93. https://doi.org/10.1186/1745-6215-13-93

Castelino, T., Fiore Jr, J. F., Niculiseanu, P., Landry, T., Augustin, B., & Feldman, L. S. (2016). The effect of early mobilization protocols on postoperative outcomes following abdominal and thoracic surgery: a systematic review. Surgery, 159(4), 991-1003. https://doi.org/ 10.1016/j.surg.2015.11.029

Choi, H., Kim, J. H., Park, J. Y., Ham, B. K., Shim, J. s., & Bae, J. H. (2014). Gum chewing promotes bowel motility after a radical retropubic prostatectomy. Asia‐Pacific Journal of Clinical Oncology, 10(1), 53-59. https://doi.org/10. 1111/ajco.12113

De Almeida, E. P. M., De Almeida, J. P., Landoni, G., Galas, F., Fukushima, J. T., Fominskiy, E., . . . Ribeiro-Jr, U. (2017). Early mobilization programme improves functional capacity after major abdominal cancer surgery: a randomized controlled trial. BJA: British Journal of Anaesthesia, 119(5), 900-907. https://doi.org/10.1093 /bja/aex250

De Castro, S. M. M., Van den Esschert, J. W., Van Heek, N. T., Dalhuisen, S., Koelemay, M. J. W., Busch, O. R. C., & Gouma, D. J. (2008). A systematic review of the efficacy of gum chewing for the amelioration of postoperative ileus. Digestive Surgery, 25(1), 39-45. https://doi.org/ 10.1159/000117822

Department of Health. (2009). National health system. Jakarta: Department of Health of the Republic of Indonesia.

Department of Health. (2011). Target of MDGs development goals. Jakarta: Department of Health of the Republic of Indonesia.

Fanning, J., & Valea, F. A. (2011). Perioperative bowel management for gynecologic surgery. American Journal of Obstetrics and Gynecology, 205(4), 309-314. https://doi.org/10.1016/j.ajog.2011.05.010

Ge, W., Chen, G., & Ding, Y.-T. (2015). Effect of chewing gum on the postoperative recovery of gastrointestinal function. International Journal of Clinical and Experimental Medicine, 8(8), 11936.

Hall, J. E., & Guyton, A. C. (2011). Guyton and Hall Textbook of Medical Physiology. Singapore: Saunders/Elsevier.

Husslein, H., Franz, M., Gutschi, M., Worda, C., Polterauer, S., & Leipold, H. (2013). Postoperative gum chewing after gynecologic laparoscopic surgery: A randomized controlled trial. Obstetrics & Gynecology, 122(1), 85-90. https://doi.org/10.1097/aog.0b013e3182983e92

Iyer, S., Saunders, W. B., & Stemkowski, S. (2009). Economic burden of postoperative ileus associated with colectomy in the United States. Journal of Managed Care Pharmacy, 15(6), 485-494. https://doi.org/10.18553/ jmcp.2009.15.6.485

Kehlet, H. (2008). Postoperative ileus—an update on preventive techniques. Nature Reviews Gastroenterology & Hepatology, 5(10), 552. https://doi.org/10.1038/ncp gasthep1230

Kozier, B., Erb, G., Berman, A., & Synder, S. J. (2010). Textbook of fundamental of nursing, processes & practices (7th ed. Vol. 1). Jakarta: EGC.

Ledari, F. M., Barat, S., Delavar, M. A., Banihosini, S. Z., & Khafri, S. (2013). Chewing sugar-free gum reduces ileus after cesarean section in nulliparous women: a randomized clinical trial. Iranian Red Crescent Medical Journal, 15(4), 330. https://doi.org/10.5812/ircmj.6458

Liu, Q., Jiang, H., Xu, D., & Jin, J. (2017). Effect of gum chewing on ameliorating ileus following colorectal surgery: a meta-analysis of 18 randomized controlled trials. International Journal of Surgery, 47, 107-115. https://doi.org/10.1016/j.ijsu.2017.07.107

Shapter, S. L., Paul, M. J., & White, S. M. (2012). Incidence and estimated annual cost of emergency laparotomy in England: is there a major funding shortfall? Anaesthesia, 67(5), 474-478. https://doi.org/10.1111/j.1365-2044. 2011.07046.x

Sjamsuhidajat, R., & Wim, d. J. (2010). Textbook of surgery. Jakarta: EGC.

Tazegül Pekin, A., Kerimoğlu, O. S., Doğan, N. U., Yılmaz, S. A., Kebapcılar, A. G., Gençoğlu Bakbak, B. B., & Çelik, Ç. (2015). Gum chewing reduces the time to first defaecation after pelvic surgery: A randomised controlled study. Journal of Obstetrics and Gynaecology, 35(5), 494-498. https://doi.org/10.3109/01443615.2014.970146

Terzioglu, F., Åžimsek, S., Karaca, K., Sariince, N., Altunsoy, P., & Salman, M. C. (2013). Multimodal interventions (chewing gum, early oral hydration and early mobilisation) on the intestinal motility following abdominal gynaecologic surgery. Journal of Clinical Nursing, 22(13-14), 1917-1925. https://doi.org/10.1111 /jocn.12172

van Bree, S. H. W., Bemelman, W. A., Hollmann, M. W., Zwinderman, A. H., Matteoli, G., El Temna, S., . . . Boeckxstaens, G. E. E. (2014). Identification of clinical outcome measures for recovery of gastrointestinal motility in postoperative ileus. Annals of surgery, 259(4), 708-714. https://doi.org/10.1097/sla.0b013e318293ee55

Vather, R., O’Grady, G., Bissett, I. P., & Phill, G. (2013). Pathophysiologic, translational and clinical aspects of postoperative ileus – A review. Paper presented at the AuPS/ASB/PSNZ 2012 Sydney Meeting.

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