Perioperative Nursing Care and Clinical Outcomes in Cold Knife Conization of the Cervix: Pre-Procedure Assessment, Intraoperative Support, and Postoperative Surveillance
Abstract
Background: Cervical dysplasia is a precursor to invasive cervical cancer, and accurate diagnosis is essential for effective management. Cold knife conization (CKC) is a surgical excisional technique that provides both diagnostic and therapeutic benefits by removing the transformation zone and abnormal epithelium for histopathologic evaluation.
Aim: This study aims to review perioperative nursing care and clinical outcomes associated with CKC, emphasizing indications, contraindications, procedural steps, complications, and interprofessional roles.
Methods: A comprehensive literature review was conducted, synthesizing evidence-based guidelines and clinical practices related to CKC. Key domains analyzed include anatomy, indications, contraindications, equipment, personnel, preparation, operative technique, complications, and nursing interventions.
Results: CKC offers superior specimen integrity and margin interpretability compared to electrosurgical techniques, reducing recurrence risk to approximately 1.4%. However, it carries notable risks, including intraoperative and delayed hemorrhage, infection, cervical stenosis, and obstetric complications such as preterm birth. Effective perioperative nursing care—spanning patient education, positioning, hemostasis monitoring, and discharge counseling—significantly mitigates these risks. Interprofessional collaboration among gynecologists, anesthesiologists, nurses, and pathologists is critical for optimizing outcomes.
Conclusion: CKC remains a gold-standard excisional procedure for high-grade cervical lesions when precise histopathologic assessment is required. Nursing interventions and team-based care are pivotal in ensuring safety, reducing complications, and supporting long-term surveillance.
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References
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Copyright (c) 2025 Rawdah mohammed Omar Alsomali, Amna Mohammed Ali wahishi, Nahlah Abdulrahman Alfaraj, Nadiyah Owaidh Almutairi, Fatimah Turki Almalki
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