# The influence of the IKAP nursing model on wound healing following vacuum sealing drainage in acute infective endocarditis: a retrospective study

## TL;DR

This study found that the IKAP nursing model may improve wound healing and reduce complications in patients with acute infective endocarditis undergoing vacuum sealing drainage, especially in the early recovery phase.

## Contribution

The study provides empirical evidence for the effectiveness of the IKAP nursing model in improving outcomes following vacuum sealing drainage for acute infective endocarditis.

## Key findings

- The IKAP nursing group had greater wound size reduction and lower pain scores at week 4 compared to the routine nursing group.
- The IKAP model was associated with a significantly reduced incidence of wound infection and other adverse events.
- The positive effects of the IKAP model were not sustained at week 8, suggesting a focus on early recovery.

## Abstract

Acute infective endocarditis (IE) presents clinical challenges due to its complex pathophysiology and potential for severe complications. Vacuum sealing drainage (VSD) is an essential treatment approach, and nursing care plays a pivotal role in patient outcomes. The Innovative Knowledge-Attitude-Practice (IKAP) nursing model is a patient-centered approach emphasizing health education, behavioral engagement, and self-management support. This study aimed to investigate the association between the IKAP nursing model and wound healing following VSD in patients with acute IE.

A retrospective analysis of 240 patients with acute IE undergoing VSD was conducted from January 2023 to December 2023. Patients were categorized into routine nursing (n = 117) and IKAP nursing (n = 123) groups based on admission period. Baseline characteristics, VSD details, laboratory results, medication usage, hospitalization details, wound size reduction, pain scores, and postoperative complications were compared. Multivariate logistic regression was performed to adjust for potential confounders.

Baseline disease-related characteristics, VSD characteristics, and several laboratory parameters did not significantly differ between the two nursing groups. The IKAP nursing group demonstrated a lower white blood cell count (9.94 ± 2.29 vs. 10.57 ± 2.14 × 109/L, P = 0.029), greater wound size reduction at week 4 (3.52 ± 0.82 vs. 3.77 ± 0.95 cm2, P = 0.034), lower pain scores at week 4 (5.45 ± 1.93 vs. 5.98 ± 1.85, P = 0.031), and reduced incidence of wound infection (0.81% vs. 6.84%, adjusted OR = 0.11, 95% CI: 0.01–0.89, P = 0.034) and other adverse events (1.63% vs. 8.55%, adjusted OR = 0.18, 95% CI: 0.04–0.84, P = 0.031) following VSD. However, these differences were not sustained at week 8.

The findings suggest a potential association between the IKAP nursing model and improved wound healing, pain management, and reduced postoperative complications in patients undergoing VSD for acute IE, particularly during the early recovery phase. Given the retrospective nature and observed attenuation of effects at week 8, prospective studies are warranted to confirm these findings.