Best evidence summary and nursing decision pathway for the nursing management of drainage-associated open surgical wounds following minimally invasive treatment for severe acute pancreatitis

BACKGROUND: This study identified, assessed, and integrated the best available evidence concerning the nursing management of drainage-associated open surgical wounds following minimally invasive treatment for severe acute pancreatitis, so as to develop nursing decision pathways and practical implementation tools for clinical practice. METHOD: This study comprised a best evidence summary followed by translation of the synthesised evidence into a nursing decision pathway and five supporting tools. According to the 6 S evidence resource model, a systematic search was conducted for evidence related to the assessment, prevention, infection recognition, exudate management, dressing selection, drainage tube exit-site care, health education and follow-up of drainage-associated open surgical wounds after minimally invasive treatment for severe acute pancreatitis. The types of evidence included clinical decisions, clinical practice guidelines, expert consensus statements, evidence summaries, best practice recommendations, clinical pathways, systematic reviews and meta-analyses. The publication date of eligible evidence sources ranged from database inception to 30 September 2025. Methodological quality was appraised using AGREE II, AMSTAR 2 and the corresponding JBI critical appraisal tools. Directness was assessed separately by comparing each source with the target population and wound context. RESULTS: Following evidence retrieval, screening and quality appraisal, 11 evidence sources met the inclusion criteria, including two clinical practice guidelines, one national health industry standard, two best-practice recommendation documents, three systematic reviews or meta-analyses, one international consensus document, one practice-oriented clinical framework and one local clinical pathway/practice tool. Thirty-five evidence statements were synthesised across the domains of multidisciplinary collaboration, wound assessment, infection recognition, exudate management, periwound skin protection, dressing selection, drainage tube exit-site care, health education, follow-up and referral. Based on the synthesised evidence, a nursing decision pathway and five practical tools were developed, including a wound assessment record form, an infection grading and management card, a dressing selection matrix, a drainage tube exit-site care checklist, and a health education and follow-up plan. CONCLUSION: This study translated dispersed wound-care evidence into an operational nursing decision pathway and five supporting tools for drainage-associated open surgical wounds following minimally invasive treatment for severe acute pancreatitis. The pathway may support more standardised and consistent nursing decision-making; however, because the evidence was largely indirect and partly practice-oriented, local adaptation and prospective clinical validation are required before routine implementation. REGISTRATION: ES20259461.