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Modified oral cryotherapy protocol associated with reduced pain in HSCT recipients with oral mucositisModified cooling protocol linked to less severe mouth pain after stem cell transplant

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Key Takeaway
Consider modified cryotherapy for mucositis pain in HSCT recipients, but recognize evidence is observational.

A retrospective cohort study evaluated an optimized nursing protocol for oral mucositis pain management in 361 hematopoietic stem cell transplant recipients. The intervention group received modified oral cryotherapy using a Kangfuxin solution ice slurry plus adjunctive bilateral cheek cryotherapy with ice packs, while the comparator group received conventional nursing practice. The primary outcome was not explicitly stated, but secondary outcomes included oral mucositis severity and pain levels.

Overall oral mucositis incidence was comparable between groups (conventional: 78.8%, optimized: 78.0%, P = 0.851). However, moderate-to-severe pain (Grade 2-3) was lower in the optimized protocol group (22.8% vs. 39.6%, P = 0.004), representing an absolute risk reduction of 16.8%. Severe pain (Grade 3) showed a 66% relative reduction (4.0% vs. 11.9%), though statistical significance was not reported for this specific comparison.

Safety and tolerability data were not reported. The study's retrospective design represents a key limitation, as it can only show association rather than establish causation. The setting and follow-up duration were also not reported. While the findings suggest a clinically feasible strategy for pain control in this population, they should be interpreted cautiously as observational evidence.

Researchers looked back at the medical records of 361 patients who had a stem cell transplant and developed painful mouth sores, a common side effect. They compared two groups: one received a modified cooling protocol using a special ice slurry in the mouth and ice packs on the cheeks, while the other received standard nursing care.

The study found that the overall rate of mouth sores was similar between the two groups. However, patients who got the modified cooling protocol were less likely to experience moderate-to-severe pain. Specifically, severe pain cases were about 66% lower in the group receiving the modified care.

It's important to know this was a retrospective study, meaning researchers analyzed past data. This type of study can show a link or association, but it cannot prove that the cooling protocol directly caused the reduction in pain. The results are promising and suggest a practical way to help manage this difficult pain, but more research is needed to confirm the findings.

What this means for you:
A modified cooling method was linked to less severe mouth pain in a study, but more research is needed to confirm it works.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
PurposeTo assess modified oral cryotherapy (OC) for pain management in hematopoietic stem cell transplant (HSCT) recipients with oral mucositis (OM).MethodsA retrospective study included 361 HSCT patients (2023-2025) stratified into Conventional Nursing Practice (CNP) group (n=170) and optimized nursing protocol (ONP) group (n=191). The ONP protocol replaced saline ice slurry with Kangfuxin solution ice slurry and incorporated adjunctive bilateral cheek cryotherapy using ice packs. Outcomes compared OM severity and pain levels (Verbal Rating Scale).ResultsBoth groups showed comparable overall OM incidence (78.8% vs 78.0%, P = 0.851). The optimized protocol was associated with moderate-to-severe pain (Grade 2–3: 22.8% vs 39.6%, ARR = 16.8%, P = 0.004), with a 66% reduction in severe pain (Grade 3: 4.0% vs 11.9%). Multivariable analysis showed that age, alcohol use, and baseline oral pathology were independently associated with OM (all P < 0.05).ConclusionModified OC incorporating Kangfuxin ice slurry and localized cheek cryotherapy was associated with OM-related pain severity without reducing overall incidence, suggesting a clinically feasible and effective strategy for pain control in HSCT recipients.
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