title: Surgical infection and malnutrition.
abstract: BACKGROUND
  Malnutrition in surgical patients is associated with delayed recovery, higher rates of morbidity and mortality, prolonged hospital stay, increased healthcare costs and a higher early re-admission rate.
  
  
  METHODS
  Data synthesis after review of pertinent literature.
  
  
  RESULTS
  The aetiology of malnutrition is multifactorial. In cancer patients, there is an abnormal peripheral glucose disposal, gluconeogenesis, and whole-body glucose turnover. Malnourished cancer patients undergoing major operations are at significant risk from perioperative complications such as infectious complications. Surgical aggression generates an inflammatory response which worsens intermediary metabolism.
  
  
  CONCLUSIONS
  Nutritional evaluation and nutritional support must be performed in all surgical patients, in order to minimize infectious complications. Enteral nutrition early in the postoperative period is effective and well tolerated reducing infectious complications, improving wound healing and reducing length of hospital stay. Pharmaconutrition is indicated in those patients, who benefit from enteral administration of arginine, omega 3 and RNA, as well as parenteral glutamine supplementation. When proximal sutures are used, tubes allowing early jejunal feeding should be used.
authors.affiliation: School of Medicine and Research Unit, Institute of Endocrinology and Nutrition, Hospital Rio Hortega, University of Valladolid. Valladolid. Spain.. Jesus@culebras.eu.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: de Luis
authors.affiliation: Member of the Royal Academy of Medicine and Surgery of Valladolid. and of the Institute of Biomedicine (IBIOMED) of the University of Leon. External Member of the Institute of Biochemical Research, Fundacion Jimenez Diaz University Hospital, Madrid, Spain.. Jesus@culebras.eu.
authors.forename: Jesus M
authors.initials: JM
authors.lastname: Culebras
authors.affiliation: School of Medicine and Research Unit, Institute of Endocrinology and Nutrition, Hospital Rio Hortega, University of Valladolid. Valladolid. Spain.. Jesus@culebras.eu.
authors.forename: Rocio
authors.initials: R
authors.lastname: Aller
authors.affiliation: Department of Microbiology. Hospital Rio Hortega, University of Valladolid. Valladolid. Spain.. Jesus@culebras.eu.
authors.forename: Jose María
authors.initials: JM
authors.lastname: Eiros-Bouza
mesh_terms: D001424:Bacterial Infections / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D044342:Malnutrition / Q000150:complications*; D018529:Nutritional Support; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D011502:Protein-Energy Malnutrition / Q000150:complications / Q000175:diagnosis