Proper nutrition is crucial in recovering after surgery, trauma, and burns. Medical Nutrition Therapy (MNT) focuses on providing the body with the necessary nutrients to support healing, minimize complications, and enhance overall recovery.
The Role of Nutrition in Surgical Recovery
Surgery induces metabolic stress, triggering inflammation, hormonal changes, and protein breakdown. This response increases the body's energy and nutrient demands, making nutrition therapy essential for preventing muscle loss, promoting tissue repair, and supporting immune function.
Key Goals of MNT in Surgery:
- Prevent malnutrition and promote healing.
- Maintain muscle mass and reduce protein catabolism.
- Support immune function and reduce the risk of infections.
- Enhance recovery and shorten hospital stays.
Preoperative Nutrition Management
- Avoid prolonged fasting before surgery. Clear fluids can be consumed up to 2 hours before anesthesia, and solid foods up to 6 hours prior.
- Carbohydrate loading with an iso-osmolar CHO drink (e.g., maltodextrin) before surgery helps reduce postoperative insulin resistance and stress.
- Nutritional risk assessment (BMI, weight loss history, albumin levels) should be conducted to identify at-risk patients.
Postoperative Nutrition Management
- Early oral feeding is preferred whenever possible to restore gut function.
- Oral nutrition supplements (ONS) are recommended for the first three days post-surgery to meet energy needs.
- Enteral nutrition (EN) is given if oral intake is insufficient, while parenteral nutrition (PN) is used for patients with non-functional gastrointestinal (GI) tracts.
- Protein intake should be prioritized to support wound healing and muscle preservation.
Enhanced Recovery After Surgery (ERAS)
ERAS protocols emphasize:
- Early mobilization to aid muscle recovery.
- Optimal fluid management to prevent dehydration.
- Minimizing stress and inflammation through proper anesthesia and pain control.
- Early reintroduction of oral feeding to restore gut function.
MNT for Trauma and Burns
Trauma and burns result in severe catabolism, increasing the body's nutritional demands significantly. Patients require high protein and calorie intake to support wound healing, maintain lean body mass, and prevent complications.
Key Nutritional Considerations:
- Increased protein intake (1.5–2.5 g/kg/day) is crucial to counteract muscle loss.
- Higher calorie needs due to hypermetabolism; energy intake should be adjusted based on the extent of injury.
- Micronutrients such as zinc, vitamin C, and vitamin A play vital roles in tissue repair and immune function.
- Enteral feeding is preferred, but parenteral nutrition is used when necessary.
Final thoughts
Proper nutrition is a cornerstone of recovery from surgery, trauma, and burns. A well-planned MNT strategy can enhance healing, reduce complications, and improve patient outcomes. Healthcare professionals must assess nutritional status early and provide tailored nutritional support to ensure optimal recovery.
