Dietary Modulation of Postoperative Inflammation: Molecular Mechanisms and Implications for Tissue Repair and Healing

Postoperative inflammation is a necessary response to surgical injury that supports tissue repair and regeneration. However, successful healing depends not only on the initial inflammatory response but also on its timely resolution. Failure to resolve inflammation can impair wound healing, promote fibrosis, and increase the risk of postoperative complications. Increasing evidence suggests that effective recovery is driven by the transition from inflammation to repair and regenerative processes. Diet plays an important role in this transition, as nutrients not only provide metabolic support but also regulate key pathways involved in inflammation, tissue regeneration, redox balance, and immune function. Omega-3 polyunsaturated fatty acids could serve as precursors for specialized pro-resolving mediators that actively terminate inflammation and may promote macrophage-driven tissue repair. Polyphenols and antioxidant micronutrients modulate NF-κB and Nrf2-dependent signalling, attenuating oxidative amplification of inflammatory cascades. Micronutrients and amino acids further regulate enzymatic processes governing collagen synthesis, angiogenesis, and immune competence. Concurrently, diet-driven preservation of gut barrier integrity limits endotoxin-mediated amplification of systemic inflammatory responses. By targeting interconnected molecular networks, including inflammasome activation, mitochondrial redox signalling, and metabolic programming of immune cells, anti-inflammatory dietary patterns may promote immune resolution rather than immunosuppression. This distinction is particularly relevant in the postoperative setting, where balanced inflammation is required for both host defence and regenerative healing. This review synthesizes current molecular and translational evidence linking dietary modulation to postoperative inflammatory control and tissue regeneration. By integrating insights from immunology, metabolism, and nutritional science, it positions diet as an active, biologically grounded component of perioperative management and highlights future directions for precision nutrition strategies aimed at optimizing surgical recovery.