Nutrition In Relation To Surgery
By Stine Thestrup, RN, PhD, post-doc, Roskilde, SUH
Introduction
The plastic surgery nurse role in educating patients about proper nutrition before and after their procedures is crucial for their successful recovery and optimal outcomes. As a plastic surgery nurse, you have the opportunity to guide patients towards making informed dietary choices that will significantly impact their plastic surgery experience. By providing preoperative and postoperative nutrition advice, you contribute to their overall well-being, successful recovery, and the achievement of optimal results. Your expertise and guidance might empower patients to prioritize their nutrition, leading to enhanced outcomes and improved satisfaction with their surgical journey (1–3).
Preoperative nutrition
Optimal Hydration
In the weeks leading up to surgery, emphasize the importance of staying well-hydrated. Proper hydration supports healthy blood circulation and helps maintain electrolyte balance.
Balanced Diet
Malnourished patients are overall at higher risk for wound infection. Educate patients on the significance of a well-balanced diet rich in proteins, whole grains, fruits, vegetables, and healthy fats.
Avoid Crash Diets
Advise against extreme diets or rapid weight loss methods before surgery, as they can lead to nutritional deficiencies and compromise the body’s ability to heal.
Avoid Alcohol and Smoking
Strongly discourage alcohol consumption and smoking as they can delay healing and increase the risk of complications. Patients attending plastic surgical procedures are recommended to quit smoking, vaping, and using all nicotine products between three and six weeks (or as early as possible) before the procedure.
Postoperative Nutrition
Protein-Rich diet
Emphasize the importance of protein for tissue repair and recovery. Encourage patients to include sources like lean meats, fish, eggs, legumes, and dairy. In addition to the importance of proteins, carbohydrates are the key source of fuel for wound healing. Most postoperative patients will resume a diet when allowed, but it is important to provide the nothing-by-mouth patient with an adequate source of glucose to prevent starvation ketosis.
Hydration
Reinforce the need for proper hydration (primarily water) post-surgery to aid in wound healing, prevent complications, and maintain overall well-being
Avoid Alcohol and Smoking
Strongly discourage alcohol consumption and smoking during the recovery period, as they can delay healing and increase the risk of complications.
MOBILIZATION/AMBULATION
Preoperative and postoperative physical activity and mobilization are integral components of plastic surgery care as this can contribute to positive patient outcomes, faster recovery, and improved overall well-being. Through individualized strategies and patient education, nurses can play a vital role in supporting plastic surgery patients achieve successful results.
Preoperative physical activity
Plastic surgery nurses play a crucial role in motivating patients to engage in physical activity before surgery. Engaging in physical activity before surgery is important to prevent complications. Physical activity refers to any bodily movement that requires energy expenditure and engages various muscles and systems of the body. It encompasses a wide range of activities that people engage in as part of their daily lives, exercise routines, sports, and recreational pursuits. Physical activity can vary in intensity, duration, and purpose, and it plays a crucial role in promoting overall health and well-being. Remember that every individual’s situation is unique, and the type and intensity of physical activity should be tailored to your patients’ specific situation (4).
Postoperative Mobilization and ambulation
Surgery is a significant medical intervention that can bring about transformative improvements in a patient’s health and well-being. While the focus is often on the surgical procedure itself, the period following surgery is equally critical for ensuring a successful outcome. One of the key factors that can greatly impact the recovery process is postoperative mobilization and ambulation – the act of getting patients up and moving shortly after surgery. The plastic surgery nurse should encourage patients to start ambulating as soon as it is safe and feasible after surgery, based on the type of procedure and individual factors (5). In hospital, the activity will most likely be very light and may include sitting, standing and walking. A gradual increase in activity levels, under the guidance of medical professionals, helps ensure a successful and healthy recovery process.
Mobilization and ambulation holds immense importance for several reasons (5–7):
Prevention of Complications
Postoperative immobility can lead to a range of complications, including blood clots, pneumonia, pressure ulcers, and muscle atrophy. Moving and mobilizing patients as soon as it is safe to do so helps prevent these complications. Physical activity stimulates blood circulation, reduces the risk of blood clot formation, and aids in maintaining the health of vital organs.
Respiratory Health
Many surgical procedures require patients to be under anesthesia, which can temporarily affect lung function and lead to shallow breathing. Early mobilization helps improve lung capacity, oxygenation, and prevents respiratory complications like pneumonia. Deep breathing exercises and walking can effectively clear the lungs of any accumulated fluids, promoting better respiratory health.
Faster Recovery
Active mobilization encourages the body’s natural healing mechanisms. It helps reduce inflammation, improves blood flow to the surgical site, and aids in the removal of waste products from the body. This accelerated healing process can result in shorter hospital stays and a quicker return to normal activities.
Muscle Strength and Joint Function
Prolonged periods of immobility can cause muscle weakness and joint stiffness. Mobilization helps maintain muscle strength, joint flexibility, and overall physical function. Engaging in controlled movement and exercises designed by medical professionals can prevent muscle atrophy and improve overall physical well-being.
Psychological Well-being
Recovery from surgery can be emotionally challenging for patients. Being immobile for extended periods can lead to feelings of helplessness and anxiety. Mobilization not only contributes to physical recovery but also boosts the patient’s psychological well-being by providing a sense of control and accomplishment.
Gastrointestinal Health
After surgery, the digestive system can slow down, leading to issues like constipation. Mobilization stimulates the digestive system, preventing complications and discomfort. Moving around aids in maintaining a healthy gut function and can alleviate postoperative gastrointestinal disturbances.
Reduction of Pain
Contrary to common belief, movement after surgery can actually help alleviate pain. Controlled, guided movement can reduce muscle tension, prevent the formation of adhesions, and promote the release of endorphins – the body’s natural pain relievers.
References
1. Roy M, Perry JA, Cross KM. Nutrition and the plastic surgeon: Possible interventions and practice considerations. Plast Reconstr Surg – Glob Open. 2018;6(8):1–3.
2. Harrison B, Khansa I, Janis JE. Evidence-Based Strategies to Reduce Postoperative Complications in Plastic Surgery. Plast Reconstr Surg [Internet]. 2016;137(1). Tilgængelig hos: https://journals.lww.com/plasreconsurg/fulltext/2016/01000/evidence_based_strategies_to_reduce_postoperative.65.aspx
3. Hotta T. Core curriculum for plastic surgical nursing: Dermal fillers. 5th Editio. Bd. 28, Plastic Surgical Nursing. International Society of Plastic and Aesthetic Nurses; 2019. 131–135 s.
4. Pritchard MW, Lewis SR, Robinson A, Gibson S V., Chuter A, Copeland RJ, m.fl. Effectiveness of the perioperative encounter in promoting regular exercise and physical activity: a systematic review and meta-analysis. eClinicalMedicine [Internet]. 2023;57:101806. Tilgængelig hos: https://doi.org/10.1016/j.eclinm.2022.101806
5. Reeana T, Gregg N, Rosie T. Early mobilization in enhanced recovery after surgery pathways: current evidence and recent advancements. J Comp Eff Res [Internet]. 1. november 2021;11(2):121–9. Tilgængelig hos: https://doi.org/10.2217/cer-2021-0258
6. Pashikanti L, Von Ah D. Impact of early mobilization protocol on the medical-surgical inpatient population: An integrated review of literature. Clin Nurse Spec. 2012;26(2):87–94.
7. Wainwright TW, Burgess L. Early Ambulation and Physiotherapy After Surgery BT – Enhanced Recovery After Surgery: A Complete Guide to Optimizing Outcomes. I: Ljungqvist O, Francis NK, Urman RD, redaktører. Cham: Springer International Publishing; 2020. s. 211–8. Tilgængelig hos: https://doi.org/10.1007/978-3-030-33443-7_23
