Surgical infection and malnutrition

Area of Science:

• Surgical Nutrition
• Clinical Metabolism
• Patient Recovery

Background:

• Malnutrition in surgical patients correlates with poor outcomes, including delayed recovery, increased morbidity and mortality, extended hospital stays, higher costs, and readmissions.
• The multifactorial causes of malnutrition, particularly in cancer patients, involve metabolic dysregulation like abnormal glucose metabolism.
• Surgical stress triggers inflammatory responses that exacerbate metabolic disturbances, increasing risks for malnourished patients.

Purpose of the Study:

• To emphasize the critical need for nutritional evaluation and support in all surgical patients.
• To highlight the benefits of early postoperative enteral nutrition in reducing complications and improving recovery.
• To identify specific pharmaconutritional strategies for high-risk patients.

Main Methods:

• Systematic literature review and data synthesis.

Main Results:

• Malnutrition is linked to significant perioperative risks, especially infectious complications in cancer patients undergoing major surgery.
• Surgical interventions can worsen intermediary metabolism due to inflammatory responses.
• Early enteral nutrition is effective in reducing infectious complications, enhancing wound healing, and shortening hospital stays.

Conclusions:

• Comprehensive nutritional assessment and intervention are essential for all surgical patients to mitigate infectious complications.
• Early postoperative enteral nutrition is well-tolerated and beneficial for reducing complications and hospital stay duration.
• Pharmaconutrition, including specific nutrients like arginine, omega-3, RNA, and glutamine, is indicated for select patients, with jejunal feeding tubes recommended for early enteral access.