Nutrition & Surgery

Impact of surgery on the body

Surgery can have a huge impact on the body and creates a ‘surgical stress response’. The ‘surgical stress response’ impact can be divided into:

  • Inflammatory Response; which is an imbalance between pro-inflammatory and anti-inflammatory systems
  • Metabolic Response; which causes catabolism (a breakdown of energy reserves) and increased cardiovascular demands, i.e. more oxygen consumed, increased cardiac output (blood pumped around the body by the heart) and salt and water retention to maintain plasma volume (the liquid aspect of blood).

The body reacts in order to maintain the delivery of nutrients and oxygen-rich blood and to mobilize energy reserves (glycogen stores, adipose fat, lean body mass). This is to maintain energy processes, repair tissues and synthesize proteins.

What does this mean?

The surgical stress response parallels the severity of the injury, i.e. the more major the surgery the bigger the surgical stress response will be. A consequence of the surgical stress response includes skeletal muscle wasting, impaired immune function, wound healing, organ failure and death. Amongst elective orthopedic procedures it is extremely unlikely to have a severe response, i.e. organ failure or death. Energy requirements increase during surgery. The body’s primary role is to ensure the vital body functions are maintained.

During the surgical process, skeletal muscle tissues are broken down to provide amino acids to enhance immune system function, support vital organ function and promote wound healing. A loss in skeletal muscles has significant effects and can be associated with:

  • Loss of aerobic capacity
  • Reduced muscle strength
  • Global Weakness
  • Fatigue
  • Insulin resistance
  • Falls and fear of falling
  • Frailty disability and mortality (an extreme reaction)
  • Increased risk of musculoskeletal injuries

Malnourishment and surgery

Malnourishment is when the body does not get the right amount of vitamins, minerals and other nutrients. People can be either undernourished or over nourished. Malnutrition increases an individual at four times greater risk of complications during and after surgery. These complications include:

  • Mortality and morbidity
  • Complications, i.e. infections, wound healing, immune response
  • Hospital re-admissions
  • Prolonged hospital stays
  • Increased healthcare costs
  • Prolonged functional recovery
  • Wound infection or impaired wound healing

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