272 Use of Spirometry for Chest Training as Part of ERAS Guidelines in Patients Post Rib Fractures and Major Colorectal Surgeries

Abstract Aim To assess compliance with the use of spirometry during the postoperative inpatient period, and to evaluate its impact on length of stay and incidence of chest infections in patients following major colorectal surgeries and rib fractures. Method A two-cycle audit was conducted in our surgical department. The audit spanned from October 2024 to May 10, 2025. Patients admitted with rib fractures or undergoing major colorectal surgeries were included. The first cycle included 103 patients and served as the baseline. Interventions to improve spirometer use were implemented prior to the second cycle, which included 53 patients. Data were collected on spirometry use, hospital stay duration, and postoperative chest infections. Results Spirometer use: Increased from 0% in the first cycle to 81.1% (43/53 patients) in the second cycle. Robotic resections: 100% received spirometers in the second cycle; none developed postoperative chest infections. Length of stay (LOS): Colorectal surgery patients: LOS reduced from 9 days to 6 days (33.3% reduction). Rib fracture patients: LOS reduced from 11 days to 8 days (27.2% reduction). Chest infections: Decreased from 9 cases in the first cycle to 4 in the second cycle (44% reduction). Conclusions Implementation of routine spirometer use postoperatively, in line with ERAS recommendations, significantly improved compliance and was associated with a reduction in hospital stay and postoperative chest infections. These findings support integrating spirometry more systematically into perioperative care for surgical and trauma patients.