NUTRITION IN SURGICAL CONDITIONS: METABOLISM FOLLOWING SURGERY
Good nutrition prior to surgery leads to effective wound healing, increases resistance to infection, shortens the period of convalescence, and lowers the mortality rate. On the other hand, poor nutrition prior to surgery results in excessive weight loss, poor wound healing, edema or dehydration, reduced motility of the gastrointestinal tract, and decubitus ulcers. The level of serum proteins, hemoglobin, and electrolytes are often reduced. Poorly nourished patients are at greater risk during and following surgery.
Catabolism and then anabolism are the normal reactions to surgery, trauma from an accident, hemorrhage, or burns. The catabolic phase usually lasts for a few days. Increased amounts of pituitary and adrenal hormones are secreted. As a result, sodium and water are often retained. There is a loss of body cells, and consequently an increase in the excretion of nitrogen and potassium. The acid-base balance may be disturbed. Peristalsis is reduced or even absent.
Wound healing represents the anabolic phase. Tissue cells are replaced, leading to positive nitrogen and potassium balance. Sodium and water losses return to normal and the body returns to its normal state of hydration. Peristalsis gradually returns to normal. This phase occurs despite the initial poor intake of food, and only emphasizes the importance of good nutrition prior to surgery or injury.
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GENERAL HEALTH

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