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Post-operative period

Surgery, surgical procedure are a great challenge and burden for patient’s organism. It should be remembered that the body’s reaction to injury or surgical procedure may be an excessive inflammatory response. Metabolism changes as well, moving towards catabolic reactions – processes during which the organism starts absorbing and consuming proteins.

Postoperative nutrition

For each patient, the most important thing is to quickly return to normal functioning after the operation, to have as few complications as possible and to be discharged from the hospital quickly. In order to achieve this, catabolism must be minimized as much as possible to enable the patient’s body to return to a state of anabolism. Nutrition plays an essential role in these processes. A liquid diet may be an important element of nutritional treatment. In more severe cases, enteral and parenteral nutrition also play a significant role.

Regardless of the method of nutrition recommended by the doctor (enteral through the feeding tube or stoma, parenteral), it should be used until the patient is able to take at least 70% of energy and protein requirements by mouth.

L-arginine is an amino acid used in protein synthesis, essential in many metabolic processes. Its deficiency often occurs after large injuriesand in cancer cachexia9. It has a beneficial effect on wound healing10. The supply of L-arginine increases the formation of nitric oxide, which takes part in the tissue repair process, including angiogenesis (formation of capillaries), union and collagen formation. In combination with other immunocomponents, L-arginine reduces the percentage of infectious complications and shortens the hospital stay, especially in patients after planned procedures.11.

As it has been shown in studies, nutritional intervention enriched with arginine before and after the surgical procedure may increase survival12.

Perioperative supplementation with immunomodeling compounds may positively modulate the immune and inflammatory response in the in vitro conditions and in patients after burns, injury or subjected to oncological surgery.

Shu X. Immunosupression and infection after major surgery: a nutritional deficiency, Crit Care Clin. 2010 Jul;26(3):491-500
Vissers YL, Plasma arginine concentrations are reduced in cancer patients: evidence for arginine deficiency? Am J Clin Nutr. 2005 May;81(5):1142-6.
10 I.B.J.G.Debats, Role of arginine in superficial wound healing in man, Volume 21, Issues 3–4, 15 December 2009, Pages 175-183.
11 Podstawy Żywienia Klinicznego edycja czwarta, pod red.Sobotka L., Scientifica 2013, s.315-322, Bartosch-Harlid, Cachexia in pancreatic cancer – Mechanisms and potential intervention, e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism 4 (2009) e337–e343.
12 Douglas MacKay, ND , Nutritional Support for Wound Healing, Alternative Medicine Review, Volume 8, Number 4, 2003.