Nutritional support has been available for approximately two decades. It has proved its value as one of the most important therapeutic modalities in this century and perhaps in the history of medicine. The gut has been a major focus on nutritional support over the past decade, and this is likely to continue.
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 pre–operative nutrition period, including both pre–operative and post–operative aspects. Many studies show that pre–operative acceptable nutritional conditions help to prevent early and late post–operative 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 had undergone an elective lumbar spinal surgery. Of 26 postoperative complications, 24 were in the malnourished group.
The authors recommend that close attention be paid to the pre–operative nutritional status of patients undergoing this surgical procedure and also said that individuals with sub optimal nutritional parameters should be supplemented and replenished before elective surgery. Based on 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 dehiscence’s.
As we can see, there is a highly significant correlation between pre–operative denutrition and post–operative morbidity. Di Costanzo et. al. say that this correlation also exists for postoperative mortality and it does not depend on whether the operation is performed in gastrointestinal tract or not, whether the primary disease is cancer or not. Successful recovery from a surgical intervention depends on many factors and post–operative nutritional support is one of these important factors. Post–operative nutrition should be initiated as soon as possible. The nutrients implemented will help in wound closure, in improving immune responses, in preventing infections or sepsis and in many other processes that play a role in the recovery period. Delaying this support may impair this period, thus putting the patient’s life at risk in addition to increase hospital stay time and costs.
