Perioperative nutritional therapy for surgical patients

ABSTRACT

Malnutrition of hospitalized patients is a prevailing issue, especially in the perioperative period. As the elderly population increases progressively, surgeons should become more alert to preventing the risk of iatrogenic malnutrition. The consequences of malnutrition, such as delayed wound healing, exposure to infection, pressure sores, gastrointestinal bacterial overgrowth, and compromised immunity can be prevented or attenuated by vigorous nutritional support. Enhanced recovery after surgery is a multimodal perioperative care pathway designed to achieve early recovery for patients undergoing major surgery, in which nutritional intervention is the most important and integral part. Preoperative nutritional assessment, intraoperative considerations against postoperative nutritional problems, and an appropriate postoperative nutritional supply will result in better outcomes of surgery, and, in turn, in reduced postoperative complications, shorter hospital stays, and decreased medical costs. Though enteral nutrition is preferable over parenteral nutrition, parenteral nutrition should be supplemented selectively in those for whom enteral nutrition will inevitably be inadequate.