Objective To explore the effect of modified Perineal Assessment Tool (PAT) combined with graded nursing program on preventing and treating incontinence-associated dermatitis (IAD) in children after transanal soave surgery for hirschsprung′s di-sease, and to provide a reference for clinical nursing. Methods Children with hirschsprung′s disease undergoing transanal soave surgery and their caregivers were selected conveniently, then they were divided into a control group (n=68) and an intervention group (n=71) chronologically.The control group received the modified PAT combined with routine nursing, while the intervention group additionally implemented a graded nursing program.The occurrence time, incidence, treatment effect of IAD and caregivers′ satisfaction were compared between the two groups. Results During the observation period, there were statistically significant differences in the incidence, occurrence time, treatment effect of IAD and caregivers′ satisfaction between the two groups (all P＜0.05). Conclusion The modified PAT combined with a graded nursing program can reduce the incidence of postoperative IAD in children, improve the treatment effect of IAD, and enhance caregivers′ satisfaction.