Nutrition plays an important role in post-surgical recovery by supporting the various phases of wound healing. Several nutrients have been shown to specifically aid the inflammatory, proliferative, and remodeling phases. A balanced diet high in protein, antioxidants, fiber, and certain supplements can help reduce healing time, morbidity, and length of hospital stay. Research demonstrates nutritional support leads to improved outcomes and reduced costs for patients who are nutritionally depleted after surgery.

1. NUTRITION IN POST SURGICAL
RECOVERY

2. Keast and Orsted wittily state,
“Best practice requires the
assessment of the whole patient, not just the
hole in the patient. All possible contributing
factors must be explored.”

3. QUICKER RECOVERY –ROLE OF
NUTRITION
• Tissue repair results in increased cellular activity,
which causes an intensified metabolic demand for
nutrients.
• Nutritional deficiencies can impede wound
healing, and several nutritional factors required for
wound repair may improve healing time and wound
outcome.

4. Factors which Impede Tissue Healing
 hypoxia, infection, tumors, metabolic disorders
such as diabetes mellitus, the presence of debris and
necrotic tissue, certain medications.
 a diet deficient in protein, vitamins, or minerals.
 In addition, increased metabolic demands are
made by the inflammation and cellular activity in
the healing wound, which may require increased
protein or amino acids, vitamins, and minerals

5. Phases of wound healing
Wound
Hemostasis
Inflammatory
Proliferative
Remodeling

6. NUTRITION IN HEALING
• Wounding
•
• Hemostasis
• Drugs, herbs, vitamins, amino acids, or minerals that effect blood-clotting
• mechanisms should be avoided prior to surgery.
• Inflammatory Phase
• Vitamin A – enhances early inflammatory phase
• Bromelain and adequate protein intake – prevent prolonging inflammatory phase
• Vitamin C – enhances neutrophil migration and lymphocyte transformation
• Proliferative Phase
• Vitamin C – necessary for collagen synthesis
• Calcium, Magnesium , Phosphorus
• Glucosamine – enhances hyaluronic acid production
• Vitamin A – promotes epithelial cell differentiation
• Zinc – required for DNA synthesis, cell division, and protein synthesis
•
• Remodeling
• Protein deficiency – inhibits wound remodeling
•

8. Patient Recovery and healing –
Nutrition components
• 1. Glutamine
• This is an amino acid (one of the building blocks of protein) that generally comes in a
tasteless powder form. It can be mixed into water or juice. Use about 1/4 teaspoon of
powder for each dose, two to three times daily. Glutamine supplementation can start as soon
as a patient can eat solid foods, which generally means about 12-14 hours post-surgery.
• 2. Omega-3 fatty acids
• The best source of omega-3s is natural, which should be taken daily. This should wait till
about two to three days after surgery to ensure it does not interfere with normal
blood clotting. Patients can eat flaxseeds , walnuts and pumpkin seeds as they are also
sources of omega-3s.
• 3. Probiotics
• Lately, probiotics are getting lots of attention as friendly bacteria that help keep bad bacteria
and fungi under control. when these colonies are disrupted (for example, by antibiotic use), it
can cause intestinal problems Patients can eat yogurt daily (which contains friendly
acidophilus and/or lactobacillus bacteria), or take a probiotic supplement. Don't consume
probiotics within two hours of an antibiotic. If the patient is on intravenous antibiotic, wait
until she transitions to oral antibiotics.

9. • 4. Antioxidants
• Best consumed in food; studies suggest that antioxidants in a tablet/ capsule don't
work in a capsule form , possibly because they work synergistically with
other flavanoids and chemical compounds present in the natural state . Consume
lots of fruit and veggies, especially dark leafy greens, citrus, berries and cherries.
• 5. Fiber
• Painkiller medications tend to cause constipation,so keep fiber intake high with
whole grains and fruits/veggies, plus a psyllium supplement (such as Metamucil) if
things are really slow.
• 6. Protein
• Other amino acids besides glutamine are involved in wound healing and tissue
regeneration, so ensure an adequate intake of easy to digest protein: lentil soups
and steamed sprouts , eggs or egg whites , low-fat dairy and soy products.
• 7. Glucosamine sulfate
• Glycosamingens are well established in the literature for the repair of connective
tissue. Aim for approximately 1500 milligrams daily.
• 8. Turmeric
• Turmeric is a potent antioxidant, anti-inflammatory, and antibiotic that is getting a
lot of attention lately in research. It can be taken in capsule form.
•
•
•
•

10. Research establishes the benefits of
Post Surgical Nutrition Support
• Nutritional support leads to improved nutritional status and clinical outcome
in severely depleted patients [11]. Studies of postoperative nutritional support
have demonstrated reduced morbidity and reduced length of hospital
stay [12]. There is also evidence that artificial nutritional support in
malnourished patients is cost effective by reducing the costs associated with
length of stay and morbidity and improved quality of life [13]
• References
(11) Beier-Holgersen SR, Boesby S: Influence of postoperative enteral nutrition on post surgical
infections.
• Gut 1996, 39:833-5. Pubmed Abstract
(12 ) Askanazi J, Starker PN, Olsson C, Hensle TW, Lockhart SH, Kinney JM, Lasala PA: Effect of
immediate post-operative nutritional support on the length of hospitalisation.
• Ann Surg 1986, 203:236-9. Pubmed Abstract
(13) Robinson G, Goldstein M, Levine G: Impact of nutritional status on DRG length of stay.