Nutrition in Surgery Pre and Post operative dietary

Nutrition in Surgery- Pre and Post operative dietary management

Good nutrition prior to and following surgery reduces: � Better wound healing � Shorter convalescence � Lower mortality Surgery results in loss of blood. Consequences are: � Reduction in circulating blood volume � Reduction in concentration of serum protein � Reduction in hemoglobin � Reduction in electrolytes

Increase in nutrient need due to: �Loss of blood, plasma or pus from the wound surface �Haemorrhage from the gastrointestinal or pulmonary tract �Vomitting �Fever �Parenteral feeding �Choice and amount of food too limited (poor appetite) �Chronic infection �Diarrhoea

Extent of deficiency manifested by : �Weight loss �Decreased intestinal motility �Poor wound healing �Anemia �Edema or dehydration �Duodenal ulcers

Nutritional considerations �Objectives are : 1. To improve the pre-operative nutrition whenever the operation is not of an emergency nature 2. To maintain and correct nutrition after operation or injury as far as possible. 3. To avoid harm from the injudicious choice of foods.

Role of nutrients �Proteins : High quality, complete protein ensures 1. Rapid wound healing 2. Resistance to infection 3. Protective action upon the liver 4. Reduces the possibility of edema *100 gm or more protein necessary as a rule

Role of nutrients �Energy 1. Sufficient calorie intake to maintain proper body weight. 2. To prevent acidosis due to excessive metabolism of body fat 3. To prevent depletion of liver glycogen *In case of febrile patient 3000 kcal diet preferable. *In case obesity low calorie diet is preferable.

Minerals �Need for phosphorus and potassium �Increase requirement of sodium and chloride due to vomitting, diaarhoea, perspiration, anorexia, diuresis or renal failure. �Electrolyte imbalance �Iron deficiency anemia

Fluids Adequate fluid is necessary to prevent: �Dehydration �Acidosis *Parenteral fluid given if intake of fluid not possible by mouth. Vitamins �Ascorbic acid to prevent wound healing �Vitamin K to prevent haemorrhage