title: Reduced postoperative infections with an immune-enhancing nutritional supplement.
abstract: OBJECTIVE
  Malnutrition is a significant risk factor for postoperative infections in patients undergoing oncologic surgery. This study was undertaken to determine if perioperative nutritional supplementation with an immune-enhancing formula is superior to standard formula in the prevention of postoperative infectious complications.
  
  
  METHODS
  This was a prospective, randomized, double-blind trial comparing perioperative nutritional supplementation with Impact and standard nutritional formulas.
  
  
  METHODS
  Following stratification, 136 patients undergoing oncologic head and neck surgery were randomly assigned to one of four treatment groups: preoperative/postoperative Impact, postoperative Impact, preoperative/postoperative standard formula, and postoperative standard formula. Outcome measures included laboratory evaluations of nutritional status, infectious and wound healing complications, and duration of hospitalization. Statistical analysis was performed using chi2 or two-tailed Fisher Exact Tests, when appropriate.
  
  
  RESULTS
  Intent-to-treat (P = .02) and actual therapy (P = .04) analyses revealed a significant decrease in the incidence of postoperative infectious complications (all sites) in patients who received Impact. There was no significant difference in wound healing problems or duration of hospitalization. Postoperative measures of nutrition status demonstrated a higher serum albumin (P = .05) in patients who received Impact compared with standard formula.
  
  
  CONCLUSIONS
  Compared with standard formula, perioperative nutritional supplementation with Impact significantly reduced the incidence of infectious complications. The length of hospitalization was significantly prolonged in patients with postoperative infections, suggesting potential cost savings with the use of immune-enhancing formulas such as Impact.
authors.affiliation: Department of Otolaryngology, University of Pittsburgh Medical Center, Pennsylvania 15213, USA. CSNYD+@Pitt.edu
authors.forename: C H
authors.initials: CH
authors.lastname: Snyderman
authors.forename: K
authors.initials: K
authors.lastname: Kachman
authors.forename: L
authors.initials: L
authors.lastname: Molseed
authors.forename: R
authors.initials: R
authors.lastname: Wagner
authors.forename: F
authors.initials: F
authors.lastname: D'Amico
authors.forename: J
authors.initials: J
authors.lastname: Bumpous
authors.forename: R
authors.initials: R
authors.lastname: Rueger
mesh_terms: D000368:Aged; D004311:Double-Blind Method; D005260:Female; D005526:Food, Formulated; D006258:Head and Neck Neoplasms / Q000276:immunology* / Q000601:surgery*; D006801:Humans; D007239:Infections / Q000178:diet therapy / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009748:Nutrition Disorders / Q000178:diet therapy* / Q000209:etiology / Q000276:immunology; D018529:Nutritional Support; D011183:Postoperative Complications / Q000178:diet therapy* / Q000276:immunology* / Q000517:prevention & control*; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000178:diet therapy / Q000276:immunology / Q000517:prevention & control; D016896:Treatment Outcome