External Validation of the New 2023 International Federation of Gynecology and Obstetrics Staging System in Endometrial Cancer Patients: 12-Year Experience from an European Society of Gynecological Oncology-Accredited Center.

Background and Objectives: The new molecular classification of endometrial cancer continuously changes the management of the disease in everyday clinical practice. Recently, FIGO released a new staging system for endometrial cancer, which incorporates molecular substages and subdivides further early-stage disease. The aim of this study was to investigate the differences between the two FIGO staging systems and evaluate the prognostic precision of the new one. Materials and Methods: We retrospectively analyzed the records of patients with endometrial cancer that were fully treated in the 1st Department of Obstetrics & Gynecology, in 2012-2023. Patient characteristics, oncological outcome, and follow-up information were collected. The primary outcomes were the stage shifts and the survival data. Results: Sixty-seven (15.5%) patients had a stage shift and the majority of them concerned early-stage disease and specifically an upshift from 2009 stages IA and IB to 2023 stage IIC. Concerning survival, a better median and 5-year PFS was present in stage II disease, and when comparing the prognostic precision of the two FIGO staging systems no significant difference was present. Conclusions: The new 2023 FIGO staging system better distinguishes early-stage endometrial cancer into its prognostic groups and seems to be as precise as the old 2009 FIGO staging system.

Complex obstetrical surgery: building a team and defining roles.

As the number of placenta accreta spectrum cases continues to rise, the gap in surgical skills in labor and delivery units becomes more apparent. Recent scholarly work has highlighted the diminishing advanced surgical skills among obstetrician-gynecologists, particularly among new graduates. Therefore, it has become a practice in many institutions to refer complex cesarean deliveries and obstetrical hysterectomies to subspecialists, specifically gynecologic oncologists. Hence, in this commentary, we propose a process through which key personnel within departments of obstetrics and gynecology are identified and their appropriate level of involvement in cases of complex obstetrical surgery is delineated. In doing so, we describe the surgical skills expected from each provider level so that the cesarean delivery complexity level can be matched with specific surgical expertise. Through this process, an obstetrician-led complex obstetrical surgery team is formed. Ultimately, the goal of this process is 2-fold; first, to return cases with higher levels of surgical complexity back to obstetricians and, second, to reduce the surgical back-up burden from gynecology subspecialists such as gynecologic oncologists.

Quality of ChatGPT-Generated Therapy Recommendations for Breast Cancer Treatment in Gynecology.

Introduction: Artificial intelligence (AI) is revolutionizing medical workflows, with self-learning systems like ChatGPT showing promise in therapy recommendations. Our study evaluated ChatGPT's performance in suggesting treatments for 30 breast cancer cases. AI's role in healthcare is expanding, particularly with tools like ChatGPT becoming accessible. However, understanding its limitations is vital for safe implementation. Material and Methods: We used 30 breast cancer cases from our medical board, assessing ChatGPT's suggestions. The input was standardized, incorporating relevant patient details and treatment options. ChatGPT's output was evaluated by oncologists based on a given questionnaire. Results: Treatment recommendations by ChatGPT were overall rated sufficient with minor limitations by the oncologists. The HER2 treatment category was the best-rated therapy option, with the most accurate recommendations. Primary cases received more accurate recommendations, especially regarding chemotherapy. Conclusions: While ChatGPT demonstrated potential, difficulties were shown in intricate cases and postoperative scenarios. Challenges arose in offering chronological treatment sequences and partially lacked precision. Refining inputs, addressing ethical intricacies, and ensuring chronological treatment suggestions are essential. Ongoing research is vital to improving AI's accuracy, balancing AI-driven suggestions with expert insights and ensuring safe and reliable AI integration into patient care.

Best original research presented at the 25th European Congress on Gynaecological Oncology: best of ESGO 2024.

The 'Best of ESGO 2024' article includes a selection of the most highly rated original research presented during the 25th Annual Congress of the European Society of Gynaecologic Oncology (ESGO), held in Barcelona, Spain, March 7-10, 2024. Of 1218 asbtracts submitted, 35 studies presented during the best oral sessions, mini oral sessions, best three minute presentations session, and young investigator session were selected by the ESGO abstract committee and the authors of the European Network of Young Gynae Oncologists (ENYGO). There was a strong focus on the surgical treatment of early stage cervical cancer and the management of advanced or recurrent gynecological cancers using induction therapy, immunotherapy, and maintenance therapy. With this work, ENYGO and ESGO aim to focus the attention of clinicians, scientists, patients, and all stakeholders interested in gynecologic oncology on research advances in the field.

Interprofessional cooperation with a dermatovenerologist - specifics of hidradenitis suppurativa management in gynaecological practice.

Hidradenitis suppurativa is a chronic immune-mediated inflammatory disease that is manifested by formation of painful nodules, abscesses and suppurating fistulas, primarily in the intertriginous spaces. This painful, often under-diagnosed disease affects much more women. They are also exposed to certain specific challenges in the management of this disease, especially during menstruation or pregnancy. The treatment requires the interdisciplinary cooperation of a dermatologist, gynaecologist, obstetrician and last but not least an algesiologist and psychotherapist. Above all, early and correct diagnosis, initiation of therapy in the early stages of the disease, is a key, which also plays a fundamental role in controlling inflammatory activity, preventing complications and further prognosis.

Ultrasound Elastography in Benign Gynecology: A Scoping Review.

OBJECTIVE: To perform a scoping review of the literature in which ultrasound elastography (UE) has been used in benign gynecology and identify avenues for its use in future research and clinical implementations. METHODS: A structured search of EMBASE, Medline and Cochrane databases was conducted (last search date April 15th, 2022). Eligible studies included adult participants with female pelvic anatomy. English language papers focusing on the utility of ultrasound elastography applied to benign gynecology were included. Narrative reviews, conference abstracts, and letters to the editor were excluded. Two independent reviewers screened titles and abstracts for inclusion, a third reviewer was consulted in cases of disagreement. Study quality was assessed by a checklist for study implementation and elastography technique. Extracted data included elastography technology, gynecologic application, opportunities for clinical implementation, and strengths and limitations. RESULTS: The search returned 2026 studies. A total of 40 studies, published between 2013 and 2022, were retained for data extraction. Studies most frequently used shear wave elastography as the method of UE (n = 23), followed by strain elastography (n = 13) and acoustic radiation force impulse (n = 4). Most common clinical applications for UE were the diagnosis of adenomyosis and uterine fibroids (27.5%), assessment of pelvic floor muscle function (22.5%), and describing the elastic properties of polycystic ovaries (17.5%) and the uterine cervix (15.0%). Limitations of the technology were identified as the lack of published reference values for gynecologic organs and difficulties in assessing tissues deep to the transducer. CONCLUSION: Future research is needed to validate the use of ultrasound elastography in gynecology under both normal and pathologic conditions.

Regenerative Medicine in Urogynecology: Where We Are and Where We Want to Be.

ABSTRACT: Pelvic floor disorders (PFDs) constitute a major public health issue given their negative effect on quality of life for millions of women worldwide and the associated economic burden. As the prevalence of PFDs continues to increase, novel therapeutic approaches for the effective treatment of these disorders are urgently needed. Regenerative medicine techniques, including cellular therapies, extracellular vesicles, secretomes, platelet-rich plasma, laser therapy, and bioinductive acellular biomaterial scaffolds, are emerging as viable clinical options to counteract urinary and fecal incontinence, as well as pelvic organ prolapse. This brief expert review explores the current state-of-science regarding application of these therapies for the treatment of PFDs. Although regenerative approaches have not been widely deployed in clinical care to date, these innovative techniques show a promising safety profile and potential to positively affect the quality of life of patients with PFDs. Furthermore, investigations focused on regeneration of the main constituents of the pelvic floor and lower urinary tract improve our understanding of the underlying pathophysiology of PFDs. Regenerative medicine techniques have a high potential not only to revolutionize treatment of PFDs but also to prevent these complex conditions.

[First-line management of infertile couple. Guidelines for clinical practice of the French College of Obstetricians and Gynecologists 2022]. / Prise en charge de première intention du couple infertile : mise à jour des RPC 2010 du CNGOF.

OBJECTIVE: To update the 2010 CNGOF clinical practice guidelines for the first-line management of infertile couples. MATERIALS AND METHODS: Five major themes (first-line assessment of the infertile woman, first-line assessment of the infertile man, prevention of exposure to environmental factors, initial management using ovulation induction regimens, first-line reproductive surgery) were identified, enabling 28 questions to be formulated using the Patients, Intervention, Comparison, Outcome (PICO) format. Each question was addressed by a working group that had carried out a systematic review of the literature since 2010, and followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE®) methodology to assess the quality of the scientific data on which the recommendations were based. These recommendations were then validated during a national review by 40 national experts. RESULTS: The fertility work-up is recommended to be prescribed according to the woman's age: after one year of infertility before the age of 35 and after 6months after the age of 35. A couple's initial infertility work-up includes a single 3D ultrasound scan with antral follicle count, assessment of tubal permeability by hysterography or HyFOSy, anti-Mullerian hormone assay prior to assisted reproduction, and vaginal swabbing for vaginosis. If the 3D ultrasound is normal, hysterosonography and diagnostic hysteroscopy are not recommended as first-line procedures. Chlamydia trachomatis serology does not have the necessary performance to predict tubal patency. Post-coital testing is no longer recommended. In men, spermogram, spermocytogram and spermoculture are recommended as first-line tests. If the spermogram is normal, it is not recommended to check the spermogram. If the spermogram is abnormal, an examination by an andrologist, an ultrasound scan of the testicles and hormonal test are recommended. Based on the data in the literature, we are unable to recommend a BMI threshold for women that would contraindicate medical management of infertility. A well-balanced Mediterranean-style diet, physical activity and the cessation of smoking and cannabis are recommended for infertile couples. For fertility concern, it is recommended to limit alcohol consumption to less than 5 glasses a week. If the infertility work-up reveals no abnormalities, ovulation induction is not recommended for normo-ovulatory women. If intrauterine insemination is indicated based on an abnormal infertility work-up, gonadotropin stimulation and ovulation monitoring are recommended to avoid multiple pregnancies. If the infertility work-up reveals no abnormality, laparoscopy is probably recommended before the age of 30 to increase natural pregnancy rates. In the case of hydrosalpinx, surgical management is recommended prior to ART, with either salpingotomy or salpingectomy depending on the tubal score. It is recommended to operate on polyps>10mm, myomas 0, 1, 2 and synechiae prior to ART. The data in the literature do not allow us to systematically recommend asymptomatic uterine septa and isthmoceles as first-line surgery. CONCLUSION: Based on strong agreement between experts, we have been able to formulate updated recommendations in 28 areas concerning the initial management of infertile couples.

Mixed methods study of attitudes on location of gynaecological oncology outpatient care: a patient and healthcare professional questionnaire.

OBJECTIVE: Gynaecological oncology place of care is often based on evolution of services, along historical professional boundaries, rather than user needs or preferences. We aimed to assess existing evidence, gather views of patients in the UK on their preferred place of outpatient care for gynaecological malignancies and evaluate alignment with preferences of healthcare professionals (HCP). METHODS: We performed a mixed methods study, including a scoping review, a patient survey and a healthcare practitioner questionnaire. We collected quantitative and qualitative data, performing content analysis to determine current practice and impact on patients. RESULTS: No studies were identified in our scoping review. We received responses from 159 patients and 54 gynaecological oncology HCPs. There was a strong preference for a dedicated gynaecological oncology setting (89% somewhat or very happy) (p<0.0001). Fifty-three percent of patients were somewhat or very unhappy to have care colocated with general obstetrics and gynaecology services. Specifically, two key themes were identified through content analysis of qualitative data from patients: 'environment and getting this right is vital'; and 'our cancer should be the priority'. HCPs underestimated the strong patient preference to be seen in dedicated units. Of those who see patients within general obstetrics and gynaecology, only 50% said patients were seen at separate times/locations from obstetric patients. CONCLUSION: This study demonstrates the significant impact of place of care on gynaecological oncology patients, which may be underestimated by HCPs.

Importância do diagnóstico por imagem em pacientes com sangramento uterino anormal / Importance of diagnostic imaging in patients with abnormal uterine bleeding

O sangramento uterino anormal é diagnóstico sindrômico comum no consultório do ginecologista e pode comprometer substancialmente a qualidade de vida. O objetivo no diagnóstico de sangramento uterino anormal é distinguir pacientes com causas estruturais (anatômicas), como pólipo, adenomiose, leiomioma, malignidade e hiperplasia, de pacientes que apresentam anatomia normal, nas quais o sangramento pode ser devido a alteração dos mecanismos de coagulação, distúrbios ovulatórios, distúrbios primários do endométrio, iatrogenia, ou ter outra causa não classificada. O diagnóstico se inicia a partir de anamnese detalhada e exame físico geral e ginecológico completos, seguidos da solicitação de exames complementares (laboratoriais e de imagem), conforme indicado. O exame de imagem de primeira linha para identificação das causas estruturais inclui a ultrassonografia pélvica. Histerossonografia, histeroscopia, ressonância magnética e amostragem endometrial para exame de anatomia patológica são opções que podem ser incluídas no diagnóstico a depender da necessidade. O objetivo deste artigo é apresentar a relevância dos exames de imagem na investigação das causas de sangramento uterino anormal.

Abnormal uterine bleeding is one of the commonest presenting complaints encountered in a gynecologist's office and may substantially affect quality of life. The aim in the diagnosis of abnormal uterine bleeding is to distinguish women with anatomic causes such as polyp, adenomyosis, leiomyoma, malignancy and hyperplasia from women with normal anatomy where the cause may be coagulopathy, ovulatory disorders, endometrial, iatrogenic and not otherwise classified. Diagnosis begins with a thorough history and physical examination followed by appropriate laboratory and imaging tests as indicated. The primary imaging test for the identification of anatomic causes include ultrasonography. Saline infusion sonohysterography, magnetic resonance, hysteroscopy, endometrial sampling are options that can be included in the diagnosis depending on the need. The aim of this article is to present the relevance of imaging exams in the investigation of the causes of abnormal uterine bleeding.

European Society of Gynaecological Oncology Guidelines for the Management of Patients with Vulvar Cancer - Update 2023.

BACKGROUND: As part of its mission to improve the quality of care for women with gynecological cancers across Europe, the European Society of Gynaecological Oncology (ESGO) first published in 2017 evidence-based guidelines for the management of patients with vulvar cancer. OBJECTIVE: To update the ESGO guidelines based on the new evidence addressing the management of vulvar cancer and to cover new topics in order to provide comprehensive guidelines on all relevant issues of diagnosis and treatment of vulvar cancer. METHODS: The ESGO Council nominated an international development group comprised of practicing clinicians who provide care to vulvar cancer patients and have demonstrated leadership through their expertize in clinical care and research, national and international engagement and profile as well as dedication to the topics addressed to serve on the expert panel (18 experts across Europe). To ensure that the statements were evidence-based, new data identified from a systematic search were reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the international development group. Prior to publication, the guidelines were reviewed by 206 international practitioners in cancer care delivery and patient representatives. RESULTS: The updated guidelines cover comprehensively diagnosis and referral, staging, pathology, pre-operative investigations, surgical management (local treatment, groin treatment, sentinel lymph node procedure, reconstructive surgery), (chemo)radiotherapy, systemic treatment, treatment of recurrent disease (vulvar, inguinal, pelvic, and distant recurrences), and follow-up. Management algorithms are also defined.

Impact of the COVID-19 pandemic on surgery for benign diseases in gynecology: A nationwide survey by the Japan Society of Obstetrics and Gynecology.

AIM: This study aimed to clarify the impact of coronavirus disease 2019 on gynecology practice in Japan, in particular, on surgeries for benign gynecological diseases. METHODS: An online questionnaire was distributed to 966 facilities in Japan, including core facilities, facilities participating in perinatal and gynecologic oncology registries, and facilities certified for training by the Japanese Society of Obstetrics and Gynecology Endoscopy. The number of surgeries performed was compared between 2019 and 2020, when the novel coronavirus disease was prevalent. RESULTS: Five hundred and eighty (58.2%) facilities responded. The total number of surgeries decreased from 129 648 in 2019 to 118 565 in 2020, by 8.5%, for all surgical procedures. However, there was a clear increase in the number of robotic surgeries performed in 2020 compared to that in 2019 for all populations. The number of total hysterectomies decreased markedly from 15 385 in 2019 to 12 531 in 2020, a fall of 10.1%. CONCLUSIONS: The number of surgeries for benign gynecological diseases decreased by 8.5% in 2020 compared to that in 2019. This value is among the lowest in the world.

Competência para o cuidado ginecológico na atenção primária à saúde sob a ótica das enfermeiras / Competencia para el cuidado ginecológico en la atención primaria a la salud bajo la óptica de las enfermeras / Competence for gynecological care in primary health care from the perspective of nurses

Objetivo: descrever cuidados ginecológicos de enfermagem realizados com competência na Atenção Primária à Saúde sob a ótica das enfermeiras. Método: pesquisa convergente assistencial realizada com 31 enfermeiras no sul do Brasil, por meio de oficinas temáticas, no período de agosto a setembro de 2020. Os dados foram analisados mediante a proposta de Creswell, apoiado pelo software IRAMUTEQ®. Resultados: emergiram quatro categorias, sendo elas (des) conhecimento das competências para realização do cuidado ginecológico; (in) satisfação profissional e o desenvolvimento de competências para o cuidado ginecológico; protagonismo e autonomia da enfermeira para realizar o cuidado ginecológico com competência na consulta de enfermagem; importância da busca pelo conhecimento para o cuidar com competência. Conclusão: o estudo possibilitou descrever os cuidados ginecológicos de enfermagem, identificar as barreiras e fragilidades no processo de cuidado ginecológico, comentar e discutir a necessidade constante da busca do conhecimento para manutenção e aquisição da competência.

Objetivo: describir cuidados ginecológicos de enfermería realizados con competencia en la Atención Primaria de Salud bajo la óptica de las enfermeras. Método: investigación convergente asistencial realizada con 31 enfermeras en el sur de Brasil, por medio de talleres temáticos, en el período de agosto a septiembre de 2020. Los datos fueron analizados mediante la propuesta de Creswell, apoyado por el software IRAMUTEQ®. Resultados: emergieron cuatro categorías, siendo ellas (des) conocimiento de las competencias para realización del cuidado ginecológico; (in) satisfacción profesional y el desarrollo de competencias para el cuidado ginecológico; protagonismo y autonomía de la enfermera para realizar el cuidado ginecológico con competencia en la consulta de enfermería; importancia de la búsqueda del conocimiento para el cuidado con competencia. Consideraciones finales: el estudio permitió describir los cuidados ginecológicos de enfermería, identificar las barreras y fragilidades en el proceso de cuidado ginecológico, comentar y discutir la necesidad constante de la búsqueda del conocimiento para el mantenimiento y adquisición de la competencia.

Objective: to describe gynecological nursing care performed competently in Primary Health Care from the perspective of nurses. Method: convergent care research conducted with 31 nurses in southern Brazil, through thematic workshops, from August to September 2020. The data were analyzed by Creswell's proposal, supported by IRAMUTEQ®. Results: four categories emerged, being (lack of)knowledge of the competencies for performing gynecological care; professional (dis)satisfaction and the development of competencies for gynecological care; protagonism and autonomy of the nurse to perform gynecological care competently in nursing consultation; importance of the search for knowledge to care competently. Final considerations: the study allowed the description of gynecological nursing care, identification of barriers and weaknesses in the process of gynecological care, commentary and discussion of the constant need to seek knowledge for maintenance and acquisition of competence.

Surgeon Attitudes Toward Concurrent Urogynecologic and Gynecologic Oncology Procedures: A Cross-sectional Survey.

IMPORTANCE: There is increasing overlap in the urogynecologic and gynecologic oncologic patient populations. To improve patient advocacy and access to care, a collaborative surgical approach may benefit this cohort. OBJECTIVE: The aim of the study was to evaluate surgeon attitudes toward performing concurrent urogynecologic and gynecologic oncology procedures. We hypothesized that most surgeons are amenable to collaboration. STUDY DESIGN: We conducted a cross-sectional questionnaire of members of the Society of Gynecologic Oncology and the American Urogynecologic Society from August to November 2020. A 23-item online survey was created to assess surgeon demographics, practice and screening patterns, and attitudes toward surgical collaboration. We also evaluated obstacles to performing joint procedures and assessed whether attitudes could be influenced by new information. RESULTS: A total of 338 surveys were included in the analysis, including 158 urogynecologists and 226 gynecologic oncologists (GOs). Most surgeons (77.8%) will recommend concurrent procedures with another specialty, and 97.8% of urogynecologists and 95.7% of oncologists currently perform joint surgical procedures. Male surgeons, regardless of specialty, were more likely to recommend staged procedures (44% vs 31%, P < 0.001), as were GOs (28% vs 10.1%, P < 0.001). However, oncologists were more likely than urogynecologists to initiate referrals for surgical collaboration (33.3% vs 14.4%, P < 0.001). CONCLUSIONS: A total of 22.2% of urogynecologists and oncologists prefer staging surgical procedures. The most common barrier to a combined procedure was logistics. Urogynecologists were more concerned about the effects of cancer treatments on healing, the use of mesh implants, and financial reimbursements as compared with GOs. Treatment delay was a significantly greater concern for the oncologists.

Recommendations of procedures to follow in the case of ovarian lesions in girls.

This study presents current recommendations of the Polish Association of Pediatric Surgeons (PTChD) regarding diagnostics and treatment of ovarian lesions in girls. They are based on many years of the authors' clinical experience as well as a review of international literature and include practical clinical guidelines. The recommendations were formulated in cooperation with the Polish Association of Pediatric Oncology and Hematology (PTOHD), Polish Pediatric and Adolescent Gynecology Section of the Polish Society of Gynecologists and Obstetricians (PTG) and Polish Pediatric Section of the Polish Society of Radiology (PLTR). Only better understanding of prepubertal ovarian biology and natural history of its pathology may help to introduce efficient and safe diagnostic and therapeutic strategies for girls. The prepared document has been supplemented with treatment algorithms.

[CNGOF clinical practice guidelines: Evaluation one year after revision of the methodology]. / Recommandations pour la pratique clinique du CNGOF : évaluation un an après révision de la méthodologie.

OBJECTIVES: To evaluate the revision of methodology of the clinical practice guidelines (CPG) of the French National College of Gynecologists and Obstetricians (CNGOF). METHOD: Three CPGs were organized in 2020 on the topics of severe preeclampsia, menorrhagia, and prophylactic surgery according to AGREE II (Apraisal of Guidelines for Research & Evaluation). Questions were presented in PICO (Population, Intervention, Comparison, Outcome) format and the grading of scientific evidence was based on the GRADE (Grading of Recommendation Assessment, Development and Evaluation) method. RESULTS: All three CPGs groups adhered to this new methodology. However, the presentation of the arguments, the formulation of the recommendations and the development of the GRADE tables were heterogeneous from one group to another. A homogenization of the presentation is proposed, as well as a guide to the critical analysis of the literature to help the experts to rate the evidence. CONCLUSION: Adherence to these quality criteria should make it easier to apply the recommendations at the national level and improve international recognition of the work done by the CNGOF.

Analysis of Effect on Infection Factors and Nursing Care of Postoperative Incision in Gynecological Cancer Patients.

PURPOSE: To study the effect on infection factors and nursing care of postoperative incision in gynecological cancer patients. METHOD: 72 patients with gynecological malignant tumors who came to the hospital from January 2019 to December 2019 were selected as the research objects. They were divided into the study group and control group by cluster random sampling. The control group was given routine nursing mode, including matters needing attention in surgery, health education, prevention of complications, and dietary guidance. The study group implemented the high-quality nursing mode on the basis of the control group. Postoperative situation, incision infection rate, and quality of life were observed and compared between the two groups. RESULTS: The control group's time to get out of bed, postoperative eating time, postoperative exhaust time, and hospital stay were longer than those of the study group. The comparison of the postoperative related conditions of the two groups showed that P < 0.05, which indicated that the difference was statistically significant. The postoperative incision infection rate in the study group was 2.78%, and in the control group, the postoperative incision infection rate was 19.44%; the postoperative incision infection rate in the study group was significantly lower than that in the control group. The difference was statistically significant, P < 0.05. The factors affecting the quality of life of patients in the study group were lower than that of the control group, and the difference was statistically significant, P < 0.05. Time to get out of bed, postoperative eating time, postoperative exhaust time, hospital stay, and quality of life were the main influencing factors of postoperative incision infection in gynecological tumors. CONCLUSION: Time to get out of bed, postoperative eating time, postoperative exhaust time, hospital stay, and quality of life were the main influencing factors of postoperative incision infection in gynecological tumors. High-quality nursing intervention had better clinical nursing effect in preventing postoperative incision infection. It should be widely used in clinical nursing.