preoperative nutritional care, nutritional status, nutrient reserve, healing and recovery

Description :   Preoperative condition is generally referred as the time phase before the beginning of any surgical

Article Details    :

Preoperative condition is generally referred as the time phase before the beginning of any surgical procedures and the cares, which have provided to the patients during this phase, are termed as pre-operative cares. Proper nutritional support is one of the most important features of pre-operative condition as it helps to make the surgical therapy effective. It mainly helps to prevent malnutrition and also helps to increase nutrient reserves within body.

Why nutritional support is needed during pre-operative condition?

• It has seen that patient, who is undergoing surgical procedure faces tremendous physical as well as psychological stress, which ultimately increases nutritional demand and this increased demand should be met by providing proper nutritional support to prevent the risk of developing post operative health hazards
• Malnutrition and micronutrient deficiencies are the common problems that cause extra burden to hospitalized patients and if these are not corrected properly then will develop several clinical complications. Nutrition plays vital role in preventing these deficiency disorders and thus helps to reduce the prevalence of complications
• It is associated with formulating diet as per the nutritional need of the patient hence helps to improve the nutritional status of the body
• Proper nutritional support is also very effective for rapid wound healing and also helps in early recovery
• It helps to decrease the risk of developing post operative infections
• Pre-operative nutritional care helps to promote the functionality of cardiovascular system, gastrointestinal tract, respiratory system and immune system thus decreases post operative mortality rate

Pre-operative Nutritional management

Energy

• Adequate energy should be provided to patient during pre-operative condition as it helps to support the increased catabolic rate of the body
• It is better to utilize carbohydrates (mainly) for energy purposes, which finally helps to spare the proteins for its tissue building activities
• If a patient is underweight then it is better to provide more energy to him or her for increasing body weight to an ideal level before surgery
• Whereas, if a patient is overweight then it is better to decrease calorie intake for facilitating weight reduction before surgery

Proteins

• The diet of a pre-operative patient should be enriched with protein especially in essential amino acids
• It is better to provide 1.2g of protein per kg of ideal body weight
• It helps to prevent malnutrition and also improves protein reserve within body that ultimately reduces post operative losses and damages
• It mainly helps to counteract the blood loss (as globin protein helps in the synthesis of hemopglobin), which will occur during surgery thus reduces the prevalence of anemia
• It is associated with preventing tissue catabolism as well
• It helps to maintain the growth and functionality of lean tissues
• Proper protein consumption is related with promoting the synthesis of immunoglobulins that help to improve the overall immunity, which helps to increase the body’s resistant power thus promotes recovery
• It helps to repair tissue damages
• It also promotes wound healing
• It is associated with improving bone mineral density thus pre-operative protein consumption is very beneficial for orthopedic surgery as well

Carbohydrates

• 60 to 65% of total calorie intake should come from carbohydrate
• It helps to provide energy
• It is also associated with improving glycogen stores in liver that in future helps to fulfill the need of calories in body (as food ingestion may be limited during post operative condition). Body will utilize stored glycogen for energy purpose. It has seen that glycogen is broken down to generate glucose which further utilizes by the body for ATP production
• It is better to avoid high fibre foods or complex carbohydrate at least 24 hours before surgery as fibre takes long time to digest
• Carbohydrate loading is also associated with reducing surgical stress on patients thus decreases the prevalence of post operative complications

Fats

• Diet should be free from excessive fat
• Excessive fried and spicy food should be avoided during this phase
• Moderate amount of fat should be provided for energy purpose and for supporting the functioning of fat soluble vitamins in body

Vitamins and Minerals

• As the need of protein and energy is increased during pre-operative condition thus proper amount of B vitamins (especially B1, B2, B3 and B6) should be supplied for facilitating metabolism
• Vitamin C should be provided for promoting the synthesis of connective tissue and it also promotes wound healing
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