Effects of comprehensive nursing care on infection prevention and recovery outcomes in women undergoing gynecological surgery.

Gynecological surgeries, such as myomectomy, oophorectomy, and total hysterectomy, are important methods for treating female reproductive system diseases. [ 1 ] Although these surgeries are commonly performed and have achieved good therapeutic outcomes, perioperative complications, particularly perioperative infections, remain one of the major issues affecting patient recovery and prognosis. [ 2 , 3 ] Perioperative infections can not only prolong hospital stays and increase medical costs, but also lead to severe complications and even threaten patients’ lives. [ 4 ] Therefore, effectively preventing and controlling perioperative infections has become a pressing issue in the treatment of gynecological surgeries. In recent years, with the development of nursing science, comprehensive nursing intervention has gradually attracted attention as a new nursing model. Comprehensive nursing encompasses continuous care before, during, and after surgery, with a focus on the integrated management of physiological, psychological, and social support. [ 5 , 6 ] Studies have shown that comprehensive nursing intervention can significantly improve perioperative conditions by means of personalized care, psychological counseling, and early rehabilitation promotion, reducing the incidence of infections, accelerating patient recovery, and enhancing patients’ quality of life. [ 7 ] However, despite the promotion and application of comprehensive nursing in some fields, its effects in gynecological surgeries have not been fully verified and studied. Currently, research on the impact of comprehensive nursing on gynecological surgery patients is limited, with most studies focusing on the comparison between conventional nursing and specific interventions, often involving a single type of surgery. [ 8 ] Given the diversity of gynecological surgeries and the varying risks of each procedure, different types of surgeries may face different infection risks and rehabilitation challenges. Therefore, a systematic evaluation of the effectiveness of comprehensive nursing intervention is particularly important. [ 9 ] The potential benefits of comprehensive nursing intervention in gynecological surgeries are reflected in several aspects. Firstly, preoperative personalized assessments and psychological interventions can effectively alleviate patient anxiety and reduce the risk of preoperative infections. Secondly, comprehensive nursing during surgery can improve surgical safety and reduce the occurrence of intraoperative complications. [ 10 ] Most importantly, postoperative comprehensive nursing focuses on early mobilization, pain management, and prevention of complications, which can effectively reduce infection rates, shorten recovery time, and improve the patient’s quality of life. [ 11 ] Moreover, the continuity of care provided after surgery helps patients receive ongoing support, reducing the risk of recurrence and promoting long-term health management. This study aims to systematically evaluate the effect of comprehensive nursing intervention on gynecological surgery patients, particularly its impact on infection control and postoperative recovery. Through a retrospective cohort study, we will assess the differences in multiple key clinical indicators between gynecological surgery patients who received comprehensive nursing intervention and those who received conventional nursing, including perioperative infection rates, inflammatory markers, antibiotic usage, and recovery outcomes. The study will first balance the baseline characteristics of the 2 groups using propensity score matching (PSM) to ensure a fair comparison of the impact of different nursing models on the research results. Through comprehensive data collection, including clinical data from the preoperative, intraoperative, and postoperative stages, this study aims to reveal the potential advantages of comprehensive nursing intervention in reducing infection rates, improving inflammatory responses, and reducing antibiotic usage. In addition, this study will focus on the impact of comprehensive nursing on postoperative recovery speed, exploring its role in improving long-term health management and quality of life for patients.

Conceptualization: Jinxin Qiu, Yuqiong Wang. Data curation: Jinxin Qiu, Yan Liu, Yuqiong Wang. Formal analysis: Yan Liu, Yuqiong Wang. Validation: Rui Zeng. Visualization: Yan Liu, Rui Zeng, Yuqiong Wang. Writing – original draft: Jinxin Qiu, Yan Liu, Rui Zeng, Yuqiong Wang. Writing – review & editing: Jinxin Qiu, Yuqiong Wang.

This study was approved by the Ethics Committee of Sichuan Jinxin Xinan Women and Children’s Hospital. This study is a retrospective cohort study that included 63 patients who underwent gynecological surgery at our hospital between February 2021 and February 2024. According to whether or not they received comprehensive nursing intervention, the patients were divided into the comprehensive nursing group and the conventional group. Among them, 24 patients were in the comprehensive nursing group, and 39 patients were in the conventional group. To eliminate the interference of confounding factors, we used PSM to match 24 individuals from the conventional group with similar baseline characteristics to the patients in the comprehensive nursing group, forming the final comparison group. This approach effectively controlled for the impact of confounding factors on the results. All clinical data were obtained from the hospital’s Hospital Information system, and patient identifiers were desensitized and anonymized prior to analysis to ensure confidentiality. Inclusion criteria: age requirements: female patients aged between 18 and 65 years. Diagnosis: all patients must have a confirmed diagnosis of a disease requiring gynecological surgery, including but not limited to myomectomy, oophorectomy, total hysterectomy, cervical cancer surgery, ovarian cancer surgery, endometriosis surgery, and other gynecological-related diseases. Surgical type: patients must undergo elective gynecological surgery (i.e., non-emergency surgery), ensuring that they have adequate time for comprehensive nursing intervention. Comprehensive nursing group: patients must receive comprehensive nursing intervention, which includes preoperative, intraoperative, and postoperative systematic care. Conventional nursing group: patients must receive conventional nursing, without specialized comprehensive nursing intervention. Informed consent: patients or their legal representatives must sign an informed consent form and voluntarily participate in the study. Exclusion criteria: emergency surgery patients: emergency surgery patients are excluded because they cannot receive comprehensive nursing intervention due to time constraints. Patients with severe comorbidities: patients with severe underlying diseases, such as heart disease, liver and kidney failure, or severe diabetes. Immunocompromised patients: patients with compromised immune systems, such as those infected with HIV or those on long-term immunosuppressive therapy. Patients not completing follow-up: patients who did not complete follow-up or were unable to provide complete data after surgery. Patients with mental disorders: patients with mental health conditions who cannot effectively cooperate with treatment. Other special situations: any other conditions that affect the study results or prevent completion of the research protocol. Gynecological surgery patients often experience intense anxiety due to reproductive system diseases (such as tumors or abnormal bleeding) and the impact of surgery on fertility and sexual health. Preoperatively, a nursing plan is formulated through individualized assessments (such as fertility needs and psychological status). Physiological assessment and optimization Detailed history collection (e.g., menstrual cycle, previous surgeries) is performed to assess coagulation function, infection risk, and nutritional status (especially for anemic patients, who need preoperative iron supplementation). Intestinal preparation is conducted according to the type of surgery (e.g., bowel clearance for laparoscopic surgery), and breathing exercises are taught to reduce postoperative pulmonary complications. Psychological intervention The Anxiety Scale (SAS) is used to screen the psychological status. The surgical procedure (such as the principles of laparoscopic pneumoperitoneum) and postoperative recovery expectations (such as scar size and recovery time) are explained to the patient using visual aids and text to alleviate concerns about “losing feminine characteristics” (e.g., hysterectomy) or impaired fertility. For patients with malignant tumors, cognitive-behavioral therapy is provided in collaboration with the psychology department to help them accept treatment outcomes. Family and social support Communication with the patient’s family is conducted to explain the necessity of the surgery and key points of caregiving (such as assisting with early postoperative mobilization). The involvement of the spouse in providing psychological support is encouraged (e.g., avoiding negative language such as “defective”). Gynecological surgeries involve operations on pelvic organs, requiring attention to patient positioning, temperature regulation, and privacy maintenance, especially during prolonged surgeries such as radical cancer surgeries. Positioning management: the appropriate position (lithotomy or supine) is selected based on the surgical procedure, and silicone pads are used to protect bony prominences (such as the sacrococcygeal region and ankles) to prevent nerve injury (a soft cushion is placed behind the popliteal fossa in the lithotomy position). Limb blood circulation is checked regularly, and the tightness of restraining bands is adjusted during the surgery. Hypothermia prevention: the operating room temperature is maintained at 24°C to 26°C, and warming blankets or heated intravenous infusion devices are used to maintain core body temperature, preventing hypothermia, which may cause coagulation dysfunction or shivering. Humanistic care: for awake patients (such as those under epidural anesthesia), real-time updates on surgical progress are provided (e.g., “the cyst has been completely removed”), reducing anxiety caused by uncertainty. For patients under general anesthesia, the success of the surgery is communicated immediately after awakening to avoid panic during the period of confusion. Postoperative care in gynecological surgery involves addressing wound healing, functional recovery (e.g., urination), and psychological adaptation, with particular attention to the differences in care between minimally invasive surgeries (such as laparoscopic surgery) and open surgeries. Pain management: a multimodal pain management approach is used. For laparoscopic surgery, nonsteroidal anti-inflammatory drugs are combined with local heat therapy. For open surgeries, a patient-controlled analgesia pump is used. Patients are also guided to use abdominal breathing to alleviate incision pulling pain, which helps prevent limitations in early mobilization due to pain. Early mobilization and functional recovery: patients are assisted in turning within 6 hours after surgery, and they are encouraged to sit at the bedside within 24 hours (for laparoscopic surgery) or gradually get out of bed (for open surgeries). Urinary function is monitored, and patients are encouraged to urinate spontaneously within 6 hours postoperatively. Heat therapy and auditory stimulation (e.g., running water sounds) are used to prevent urinary retention. Complication prevention: infection prevention: daily assessment of the perineal incision or abdominal drainage fluid (e.g., cloudy or foul-smelling fluid may indicate infection) is conducted. Patients are instructed that they can take sponge baths 24 hours after surgery, avoiding vaginal douching. Deep vein thrombosis prevention: patients are guided to perform ankle pump exercises 3 times daily, and high-risk patients (such as those undergoing cancer surgery) use pneumatic compression devices. Abdominal distension relief: after laparoscopic surgery, patients are encouraged to chew gum to stimulate bowel motility, while patients who undergo open surgery are given abdominal circular massages to promote gas expulsion. Psychological and social function reconstruction: the psychological status of patients is assessed within 3 days after surgery (e.g., changes in self-identity for patients who underwent hysterectomy), and targeted counseling is provided. For patients with malignant tumors, support groups for cancer patients are introduced to share recovery experiences. Social roles (e.g., plans for returning to work) are gradually reestablished. The recovery period for gynecological surgery is long, and continuity of care is essential to reduce the risk of recurrence (such as fibroid regrowth) and improve long-term prognosis. Home rehabilitation guidance: an individualized rehabilitation plan is developed, including incision care (e.g., identifying signs of redness, swelling, or discharge), pelvic floor muscle exercises (Kegel exercises, 3 sets per day), and guidance on resuming sexual activity (typically 6–8 weeks after surgery). For patients with malignant tumors, regular follow-up examinations (e.g., HPV, TCT) and compliance with chemotherapy and radiotherapy are emphasized. Remote follow-up support: a WeChat group or nursing app is used to push rehabilitation knowledge (e.g., precautions for hormone replacement therapy). Online support is provided to answer questions regarding abnormal symptoms (e.g., abnormal vaginal bleeding or persistent abdominal pain). For elderly or homebound patients, community nurses are arranged to conduct home visits (e.g., 1 week and 1 month post-surgery). Long-term health promotion: specific guidance is provided for different types of surgeries: Hysterectomy: Management of menopausal symptoms (e.g., hot flashes, insomnia), prevention of osteoporosis (calcium and vitamin D supplementation). Ovarian cyst surgery: recurrence monitoring (e.g., regular ultrasound checks), endocrine regulation advice (e.g., soybean isoflavone intake). Hysteroscopic surgery: menstrual cycle tracking (e.g., warning signs for abnormal bleeding), pregnancy planning consultation (e.g., timing for conception after submucosal fibroid resection). Preoperative care includes basic assessments and preparations, verification of the patient’s medical history and allergy history, and instructions on fasting (8 hours) and drinking restrictions (4 hours). Surgical site preparation is performed (e.g., abdominal or perineal area), with special cleaning of the navel for laparoscopic surgery. The patient is provided with a brief explanation of the surgical procedure and postoperative care instructions to relieve preoperative anxiety, emphasizing key cooperation points (e.g., early postoperative mobilization). Assistance is provided to ensure the patient is placed in the correct surgical position (lithotomy/supine position), with soft pads used to protect bony prominences and prevent pressure sores. Strict aseptic techniques are followed, vital signs are monitored, and the room temperature (22–24°C) is regulated. Warming devices are used to prevent hypothermia. For patients under local anesthesia, brief reassurance is provided, and the patient is updated on the progress of the surgery. Within 2 hours after surgery, the patient’s consciousness, vital signs, and incision bleeding are closely monitored, and analgesics are administered as needed. At 6 hours post-surgery, assistance is given to help the patient turn in bed, and within 24 hours, gradual mobilization is encouraged to promote gas expulsion and prevent thrombosis. Urinary function is monitored to prevent urinary retention. The surgical incision is inspected daily, and it is kept clean and dry. The patient’s diet is gradually advanced from liquids to solid food, focusing on high-protein and high-fiber options. The patient is advised to keep the incision dry and avoid lifting heavy objects for 2 weeks. Bathing and sexual activity are prohibited for 6 weeks post-surgery. Instructions are provided to recognize abnormal symptoms (e.g., fever > 38.5°C, redness, or discharge from the incision site). Telephone follow-up is scheduled for 1 week and 1 month after surgery. This study employed a multi-source data collection method, comprehensively gathering clinical data from the hospital information system, surgical anesthesia system, and laboratory information system. In the collection of baseline data, demographic characteristics were directly obtained through electronic medical records, with age accurately calculated from the patient’s ID information on the day of surgery. Weight and height were measured by nursing staff upon admission using calibrated electronic scales and height measurement tools, and body mass index (BMI) was calculated using the standard formula. The type of surgery was independently confirmed by 2 senior physicians based on surgical records and ICD codes, ensuring the accuracy of classification. Preoperative assessment indicators followed a strict standardized process: laboratory indicators were determined using the hospital’s routine testing methods. Hemoglobin and albumin were measured using the Sysmex blood cell analyzer and Hitachi biochemical analyzer, respectively. Psychological assessment was performed face-to-face by trained nurses using the standardized SAS scale on the day before surgery. Regarding surgical parameters, the surgery duration was extracted from the anesthesia records, calculating the exact time difference from “skin incision” to “suture completion.” Intraoperative blood loss was measured using a combination of suction and gauze weighing methods, with real-time documentation by the circulating nurse. Infection-related diagnostic indicators followed clinical standards strictly: incision infection was diagnosed based on CDC criteria, urinary tract infection required positive urine culture combined with clinical symptoms, and pelvic infection required imaging evidence accompanied by fever. Infection severity was classified into 3 levels, based on treatment modalities and objectively assessed. Postoperative inflammatory indicators were collected strictly within 24 ± 2 hours and 72 ± 2 hours after surgery, with testing conducted using standardized methods, including electrochemiluminescence and timed turbidimetric methods. The documentation of antibiotic use was detailed: prophylactic use duration was calculated from the first dose before surgery to the last dose, while therapeutic use required confirmation by an infectious disease physician based on clear evidence of infection. All data collection processes were subject to rigorous quality control, including daily calibration of instruments, data logic verification, standardized training for data collectors, and blind evaluations. These measures ensured the reliability and scientific integrity of the research data. This systematic and standardized approach to data collection provided strong support for the authenticity of the study’s results. This study employed standardized statistical methods for data analysis. Continuous variables were expressed as mean ± standard deviation if normally distributed and compared between groups using independent-samples t tests; otherwise, they were presented as median (interquartile range) and analyzed using the Mann–Whitney U test. Categorical variables were summarized as counts (percentages) and compared using the χ² test when expected frequencies were sufficient, or Fisher exact test when cell counts were small. To control for baseline confounding factors, PSM was performed. Propensity scores were estimated using a logistic regression model with the following covariates: age, weight, BMI, type of surgery (uterine myomectomy, ovarian cystectomy, cervical cancer surgery, and other gynecological procedures), and medical history (hypertension, diabetes, hyperlipidemia, smoking history, and alcohol history). A 1:1 nearest-neighbor matching algorithm without replacement was applied, with a caliper width of 0.2 times the standard error of the logit of the propensity score, resulting in 2 well-balanced cohorts. For the dynamic changes in postoperative inflammatory markers, a mixed-effects model was used, incorporating time, group, and other fixed effects, as well as individual random effects. All statistical analyses were performed using SPSS version 26.0 (International Business Machines Corporation (IBM), Armonk) and R version 4.0.3 (The R Foundation for Statistical Computing, Vienna), with a 2-tailed significance level of α = 0.05.

A comparison of baseline characteristics between the comprehensive nursing group and the conventional group was performed. Before PSM, significant differences were found between the 2 groups in terms of age and BMI. The mean age of the comprehensive nursing group was significantly lower than that of the conventional group (45.2 ± 8.1 years vs 50.1 ± 7.3 years, P  = .02), and the BMI of the conventional group was higher than that of the comprehensive nursing group (27.0 ± 3.5 vs 24.6 ± 4.3, P  = .04). These differences could potentially affect the study results. After PSM, the differences between the 2 groups in all key variables were significantly reduced. After matching, there were no significant differences in age (45.3 ± 8.3 years vs 45.1 ± 7.9 years, P  = .92) or BMI (24.4 ± 4.1 kg/m² vs 24.7 ± 4.2 kg/m², P  = .82). Additionally, no significant differences were found between the 2 groups in terms of surgery type and medical history after matching ( P values ranged from .60–1.00). PSM effectively balanced the baseline characteristics between the 2 groups, ensuring the comparability of the subsequent analyses and reducing the influence of confounding factors (Table 1 ). Baseline characteristics. The bold values indicate statistically significant P <.05. In terms of preoperative status, before propensity score matching, there were no significant differences in baseline inflammatory markers (hemoglobin, albumin, white blood cell count (WBC), C-reactive protein [CRP]) between the conventional group and the comprehensive nursing group (all P  > .05). However, the preoperative anxiety scores (SAS) of the conventional group were significantly higher than those of the comprehensive nursing group. After matching, the SAS scores between the 2 groups became similar (53.0 ± 6.9 vs 52.5 ± 6.5, P  = .80), and other physiological indicators (e.g., hemoglobin, albumin) remained balanced (all P  > .05). Regarding surgical parameters, before matching, the conventional group had significantly higher intraoperative blood loss than the comprehensive nursing group. However, there were no significant differences in surgical duration (132.8 ± 40.1 vs 120.5 ± 35.2 minutes, P  = .21) or anesthesia type distribution (general anesthesia proportion: conventional group 76.9% vs comprehensive nursing group 75.0%, P  = .89). After matching, the difference in intraoperative blood loss disappeared (150 [85–230] mL vs 145 [80–240] mL, P  = .92), and surgical parameters were balanced between the 2 groups (all P  > .05) (Table 2 ). Comparison of preoperative status and surgical parameters before and after matching. The comprehensive nursing intervention group demonstrated a significant advantage in controlling perioperative infections. The overall infection rate in the comprehensive group was 8.3% (2/24), significantly lower than the 25.0% (6/24) observed in the conventional group ( P  = .04). For specific infection types, the incidence of incisional infection was lower in the comprehensive group [1 superficial (4.2%) and 0 deep cases] compared with the conventional group [3 superficial (12.5%) and 1 deep case (4.2%)], with a statistically significant difference ( P  = .03). Similarly, the rate of urinary tract infections was reduced in the comprehensive group (8.3% vs 20.8%, P  = .02). Pelvic infections (0 vs 2 cases, 8.3%) and pulmonary infections (0 vs 1 case, 4.2%) occurred only in the conventional group. However, due to the very small number of events, statistical tests were not performed, and P values were not reported. Nevertheless, a trend toward lower infection risk was consistently observed in the comprehensive group (Table 3 ). The effect of comprehensive nursing intervention on perioperative infection-related indicators (infection incidence). The bold values indicate statistically significant P <.05. Regarding the severity of infections, all infections in the comprehensive nursing group were classified as mild (8.3%), whereas in the conventional nursing group, in addition to 4 cases of mild infection (16.7%), there were 2 cases of moderate infections (8.3%). Although the differences in the severity grading of infections between the 2 groups did not reach statistical significance ( P  > .05), the occurrence of moderate infections in the conventional nursing group is clinically noteworthy. It is important to highlight that no cases of severe infections occurred in either group (Table 4 ). The effect of comprehensive nursing intervention on perioperative infection-related indicators (infection severity). The 2 groups showed significant differences in postoperative inflammatory responses. For CRP levels, the median CRP value on day 1 post-surgery in the comprehensive nursing group was 8.5 mg/L (IQR: 5.2–12.0), significantly lower than the 14.3 mg/L (IQR: 9.8–18.5) in the conventional nursing group ( P  = .02). This difference persisted on day 3 post-surgery, with the comprehensive nursing group having a CRP value of 12.5 mg/L (8.0–16.0), while the conventional nursing group had a CRP value of 18.7 mg/L (12.3–24.5) ( P  = .03). WBC changes also showed intergroup differences. On day 1 post-surgery, the average WBC in the comprehensive nursing group was (9.8 ± 1.9) × 10⁹/L, significantly lower than the (12.4 ± 2.6) × 10⁹/L in the conventional nursing group ( P  = .01). By day 3 post-surgery, the WBC in the comprehensive nursing group had decreased to (8.2 ± 2.1) × 10⁹/L, while the conventional nursing group remained at a higher level of (10.5 ± 3.4) × 10⁹/L ( P  = .01). Procalcitonin (PCT), a sensitive marker for infection, showed a similar trend to CRP and WBC. On day 1 post-surgery, the median PCT value in the comprehensive nursing group was 0.12 μg/L (0.08–0.25), significantly lower than the 0.28 μg/L (0.15–0.45) in the conventional nursing group ( P  = .04). On day 3 post-surgery, the PCT value in the comprehensive nursing group was 0.15 μg/L (0.10–0.30), while in the conventional nursing group, it was 0.35 μg/L (0.20–0.60) ( P  = .02) (Table 5 ). Postoperative biomarkers. The results from the mixed-effects model analysis showed that the CRP levels in patients increased over time after surgery. The model intercept was 8.15 mg/L (95% CI: 6.32–9.98), indicating the initial CRP level postoperatively. The CRP value increased by 2.1 mg/L per day (95% CI: 1.65–2.55). Patients in the comprehensive nursing group had an overall CRP reduction of 1.85 mg/L (95% CI: −3.20 to −0.50) compared to the conventional nursing group. Additionally, the interaction coefficient between time and nursing group was −0.35 (95% CI: −0.64 to −0.06), showing that the CRP increase rate was slower in the comprehensive nursing group. All of the above results were statistically significant ( P  < .05) (Table 6 ). Longitudinal changes in CRP levels analyzed by mixed-effects model. The bold values indicate statistically significant P <.05. CRP = C-reactive protein. The study results showed significant differences in antibiotic usage between the 2 groups. Regarding the duration of prophylactic antibiotic use, the comprehensive nursing group had a median duration of 3 days (IQR: 2–4 days), which was significantly shorter than the 5 days (IQR: 4–6 days) in the conventional nursing group ( P  = .01). In terms of therapeutic antibiotic usage, the comprehensive nursing group had an antibiotic use rate of 12.5% (3/24), which was significantly lower than the 33.3% (8/24) in the conventional nursing group, and this difference was statistically significant ( P  = .04) (Table 7 ). Antibiotic usage.

Gynecological surgeries play a crucial role in the treatment of female reproductive system diseases, but perioperative complications, particularly infections, remain one of the major challenges affecting patient recovery and prognosis. [ 12 ] Perioperative infections not only extend hospital stays, increase medical costs, but can also lead to severe complications, or even threaten the patient’s life. [ 13 ] Therefore, it is especially important to adopt effective nursing interventions to prevent infections, accelerate recovery, and improve patient outcomes. Comprehensive nursing, as a holistic nursing intervention model, encompasses preoperative, intraoperative, postoperative, and post-discharge care and has been shown to improve patient health, reduce infection rates, and promote postoperative recovery. [ 14 ] The results of this study demonstrate that comprehensive nursing interventions significantly reduced perioperative infections in gynecological surgery patients, further validating the value of comprehensive nursing in gynecological surgeries. Firstly, this study found that the total infection rate in the comprehensive nursing group was significantly lower than that in the conventional nursing group (8.3% vs 25.0%, P  = .04). This result indicates that comprehensive nursing intervention has a positive impact on controlling perioperative infections. Comprehensive nursing, through personalized preoperative assessments and psychological interventions, can effectively alleviate patients’ anxiety, reduce preoperative stress responses, and thus reduce postoperative immune suppression, improving the body’s ability to resist infections. Additionally, intraoperative nursing measures such as positioning management, hypothermia prevention, and aseptic techniques significantly reduced the risk of infections. [ 15 , 16 ] Postoperatively, interventions such as multimodal pain management, early mobilization promotion, and complication prevention helped accelerate recovery and further reduce infections. These results are consistent with the theory of evidence-based nursing, which advocates for providing personalized care by combining the best evidence with clinical practice to maximize patient health outcomes. [ 17 ] Secondly, in the comparison of specific infection types, the incision infection rate and urinary tract infection rate in the comprehensive nursing group were 4.2% and 8.3%, respectively, significantly lower than those in the conventional nursing group (incision infection rate 16.7%, urinary tract infection rate 20.8%). These results suggest that comprehensive nursing intervention not only reduces the overall infection rate but also plays a crucial role in decreasing the occurrence of specific types of infections. The reduction in incision infections may be closely related to detailed preoperative wound care, aseptic techniques during surgery, and early postoperative interventions. The decrease in urinary tract infections could be attributed to the timely assessment and intervention of postoperative urinary function in the comprehensive nursing group, as well as the early encouragement of patient mobilization. This likely helped prevent complications such as urinary retention, thereby reducing the risk of urinary tract infections. [ 18 ] In terms of postoperative inflammatory marker changes, this study found that the levels of CRP, WBC, and PCT in the comprehensive nursing group were significantly lower than those in the conventional nursing group. These differences remained significant on day 3 post-surgery ( P  < .05). This indicates that comprehensive nursing not only effectively reduces postoperative inflammation but also accelerates the resolution of inflammation. Through timely postoperative pain management, early mobilization, and complication prevention, comprehensive nursing helps patients recover quickly, thus reducing the duration of postoperative inflammation. Furthermore, the comprehensive nursing group had significantly shorter antibiotic usage compared to the conventional nursing group. This suggests that comprehensive nursing can effectively reduce unnecessary antibiotic use, minimizing the risk of antibiotic resistance, and aligns with current antibiotic use guidelines and clinical evidence-based nursing practices. [ 19 , 20 ] It is important to note that infection risks and recovery trajectories vary substantially across different types of gynecological surgeries. For example, radical procedures for malignant tumors such as cervical cancer often involve longer operative times, greater tissue dissection, and higher physiological stress, all of which increase the likelihood of perioperative infections and delay postoperative recovery. In contrast, minimally invasive surgeries for benign conditions, such as laparoscopic myomectomy or ovarian cystectomy, are associated with shorter hospital stays and lower complication rates. Comprehensive nursing interventions may therefore exert differentiated effects depending on the surgical context: potentially playing a more pronounced role in high-risk, complex surgeries by reducing infection and facilitating functional recovery. Future studies with larger sample sizes should consider stratified analyses by surgical type to better delineate these differential benefits. However, this study has several limitations. First, as a retrospective cohort study, it is subject to potential selection bias and information bias, and the influence of unmeasured confounding factors cannot be entirely excluded. Although we applied propensity score matching to balance baseline characteristics, residual confounding may still exist. Second, the sample size was relatively small and drawn from a single institution, which may reduce the statistical power of the analyses, increase the uncertainty of effect estimates, and limit the generalizability of the findings. Moreover, the limited number of cases prevented stratified analyses by surgical type. Given the heterogeneity in infection risk and recovery trajectories between minimally invasive procedures and radical oncological surgeries, this may have introduced bias into our results. Future studies with larger sample sizes, ideally designed as multi-center prospective cohorts, are needed to validate these findings and to further clarify the differential effects of comprehensive nursing interventions across various gynecological surgeries. Overall, the results of this study indicate that comprehensive nursing interventions can significantly reduce perioperative infection rates, alleviate postoperative inflammation, shorten antibiotic usage time, and promote rapid postoperative recovery in gynecological surgery patients. These results provide strong evidence supporting the application of comprehensive nursing in gynecological surgeries. Future studies should aim to expand the sample size and conduct multi-center validation to provide more personalized and evidence-based nursing services for gynecological surgery patients, ultimately improving treatment outcomes and quality of life for patients.