Surgery always means a certain amount of risk to your well being. Surgery is a deliberate, skillful injury to your body. It may take you several weeks to months to heal. Infections and blood loss are two possible complications that your surgeon will want to help you avoid.
You can do your part to make sure you heal well without problems. You can do this by choosing the most nutritious diet. Using supportive supplements for some weeks before having an operation is also helpful. Surgery is a big event. It makes sense to give yourself extra nutrition so you can replace any blood loss. Better nutrition can also help your incisions heal. Your diet and nutritional supplements will provide the raw materials your immune system needs to protect you against infection. These same nutritional elements are what you will use to repair your skin, nerves, blood vessels, muscle and bone. Getting good nutrition will help you make the best of your surgery.
The Importance Of A Satisfactory Nutritional Status In Surgical Patients
It is known that nutritional status is a very important factor in the recovery process from all kind of surgical interventions. The concept of nutritional status in surgery evolves all the perioperative nutrition period, including both preoperative and postoperative aspects. Many studies show that preoperative acceptable nutritional conditions help to prevent early and late postoperative complications. Klein et. al. published in 1996 a study that compared 2 groups of patients: a previously malnourished one and another in agreeable nutritional conditions. Both groups undergone in elective lumbar spinal surgery.
Of 26 postoperative complications, 24 were in the malnourished group. The authors recommend that close attention be paid to the perioperative nutritional status of patients undergoing in this surgical procedure and also say that individuals with suboptimal nutritional parameters should be supplemented and replenished before elective surgery. Based in many other studies, we can say that these conclusions can be taken as true not only for spinal surgeries but for all kind of operations, always with special and particular considerations. In midline laparotomies, malnutrition is one of the well known risk factors determining wound dehiscences.
Alternative Or Nonconventional Fuels
Glutamine as a fuel for enterocytes has received much attention, with several recent clinical trials. Small insignificant changes in nitrogen balance result from a dipeptide glutamine ester. However, in severe stress, such as bone marrow transplant, a beneficial effect of glutamine in decreasing hospital stay, increasing nitrogen balance and decreasing infection rates has been demonstrated. These effects have been attributed to improved gut barrier function, but improved gut and hepatic protein synthesis are equally possible.
Nutritive solutions enriched with arginine, RNA and omega-3 fatty acids are also important fuels that influence positively the postoperative recovering of many plasma parameters which reflect patient's recovering from surgery. These "enriched solutions" are a better choice than standard diets in improving parameters such as prealbumin concentration, retinol binding protein concentration, delayed hypersensivity responses, phagocytic ability of monocytes and concentration of IL-2 receptors. People who receive the enriched solution has the same risk of developing postoperative infections if compared with people who receive the standard diet, but the infections in the latter group tend to be much more severe and difficult to treat.
It is also important to say that all the other nutrients must be remembered. Vitamins and minerals are necessary and must be administrated within the nutritional support plan.
Indications For Nutritional Support
The indications for nutritional support should consider the following:
- The premorbid state (healthy or otherwise)
- The current nutritional status
- Age of the patient
- Duration of starvation
- Degree of the anticipated insult
- The likelihood of resuming normal intake soon
- Weight loss of 15% and
- A serum albumin value less than 3 g / 100 ml.
This is the first part of "Nutrition & Surgery" topic. The second part is in another article and will discuss the enteral and parenteral routes of administration; their concepts, advantages and eventual complications.
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