Role of Micronutrients in Perioperative Care: A Systematic Review

Micronutrient adequacy is essential for wound healing, immune competence, antioxidant defense, and erythropoiesis, all critical to perioperative recovery. Deficiencies in iron, vitamin C, vitamin D, selenium, and zinc are common in surgical patients and may worsen outcomes. This review evaluated evidence linking micronutrient status or supplementation with surgical outcomes.

A PRISMA-based systematic review of major databases and trial registries (through August 2025) included randomized controlled trials (RCTs) and observational studies assessing endpoints such as wound healing, surgical-site infection, transfusion, organ dysfunction, pain, and length of stay. Risk of bias was assessed using standard tools. Narrative summarization of data was done because the outcome measures and study designs were different in eligible studies.

Twenty-two studies met the inclusion criteria. Intravenous iron consistently increased hemoglobin and iron stores but showed variable transfusion effects. Vitamin C supplementation reduced perioperative pain and modestly improved wound healing. Selenium normalization did not translate into outcome benefits. Low vitamin D and zinc levels were associated with higher infection rates and delayed healing, though interventional evidence remains limited. The results of individual studies were put into perspective using the previously published systematic reviews.

Routine high-dose supplementation is not justified. Targeted preoperative screening and correction of iron, vitamin D, zinc, and selenium deficiencies may improve recovery in high-risk surgical patients. Further large, standardized trials are needed to define optimal timing, dosing, and clinical benefits.

Banerjee D, Yadav R. Role of Micronutrients in Perioperative Care: A Systematic Review. Indian J Crit Care Med 2026;30(3):244-254.