Blind nasoenteric tube insertion using a pharmaco-mechanical synergy protocol in frail older adults with chronic wounds: a retrospective study.

OBJECTIVE

This study aimed to evaluate the feasibility and preliminary outcomes of a pharmaco-mechanical synergy protocol for blind nasoenteric tube (NET) insertion in frail older adults with chronic wounds.

METHODS

We conducted a retrospective analysis of 21 older chronic wound patients who underwent the protocol-guided blind NET insertion in our Wound and Ulcer Repair Department between October 20, 2021, and May 16, 2025. We assessed procedural success rates, complication rates, nutritional markers, and infection indicators, comparing pre-insertion baseline values with measurements taken 7 days post-insertion.

RESULTS

The overall procedural success rate was 76.2% (16/21). The mean total insertion time was 40 ± 9.2 min, with a mean insertion depth of 101 ± 11.0 cm. The procedure demonstrated a favorable safety profile, with no significant perturbations in vital signs-heart rate, respiration, mean arterial pressure, or oxygen saturation-and no insertion-related complications were observed. Nutritional status improved significantly following intervention: serum total protein and albumin levels showed statistically significant improvement (p < 0.05), while prealbumin levels exhibited a strong trend toward improvement, approaching statistical significance (p = 0.05). In contrast, infection markers showed no statistically significant changes post-procedure (p > 0.05). Learning curve analysis indicated rapid skill acquisition among nursing staff, with procedural time stabilizing between 30-50 min after an initial learning phase.

CONCLUSION

The pharmaco-mechanical synergy protocol for blind NET insertion in frail older adults with chronic wounds is associated with high success rates and a favorable safety profile. Our findings suggest this approach significantly improves nutritional status independent of underlying inflammatory states and demonstrates a replicable learning curve. Combined with its low-cost nature, this protocol represents a promising strategy for broad clinical dissemination, particularly in resource-conscious healthcare environments.