TY - JOUR
T1 - The effect of preoperative oral nutritional supplementation on surgical site infections among adult patients undergoing elective surgery
T2 - A systematic review and meta-analysis
AU - Cadili, Lina
AU - van Dijk, Pim A. D.
AU - Grudzinski, Alexa L.
AU - Cape, Jennifer
AU - Kuhnen, Angela H.
N1 - Funding Information: The authors would like to acknowledge Professor Michael Stoto, Adjunct Professor of Biostatistics at the Harvard T.H. Chan School of Public Health for his guidance and input. Publisher Copyright: © 2023 Elsevier Inc.
PY - 2023/9
Y1 - 2023/9
N2 - Introduction: Mixed findings are reported on the effect of oral nutritional supplements in reducing Surgical Site Infections (SSIs). Material and methods: PubMED, EMBASE and Cochrane were searched. Studies from inception to July 2022 were included if they involved adults undergoing elective surgery and compared preoperative macronutrient oral nutritional supplements to placebo/standard diet. Results: Of 372 unique citations, 19 were included (N = 2480): 13 RCTs (N = 1506) and 6 observational studies (N = 974). Moderate-certainty evidence suggested that nutritional supplements SSI risk (OR 0.54, 95% C.I. 0.40–0.72, N = 2718 participants). In elective colorectal surgery, this risk-reduction was 0.43 (95% C.I. 0.26–0.61, N = 835 participants) and among patients who received Impact 0.48 (95% C.I. 0.32–0.70, N = 1338). Conclusion: Oral nutritional supplements prior to adult elective surgery may significantly reduce SSIs, with an overall 50% protective effect. This protective effect persisted in subgroup analysis of colorectal surgery patients and the use of Impact.
AB - Introduction: Mixed findings are reported on the effect of oral nutritional supplements in reducing Surgical Site Infections (SSIs). Material and methods: PubMED, EMBASE and Cochrane were searched. Studies from inception to July 2022 were included if they involved adults undergoing elective surgery and compared preoperative macronutrient oral nutritional supplements to placebo/standard diet. Results: Of 372 unique citations, 19 were included (N = 2480): 13 RCTs (N = 1506) and 6 observational studies (N = 974). Moderate-certainty evidence suggested that nutritional supplements SSI risk (OR 0.54, 95% C.I. 0.40–0.72, N = 2718 participants). In elective colorectal surgery, this risk-reduction was 0.43 (95% C.I. 0.26–0.61, N = 835 participants) and among patients who received Impact 0.48 (95% C.I. 0.32–0.70, N = 1338). Conclusion: Oral nutritional supplements prior to adult elective surgery may significantly reduce SSIs, with an overall 50% protective effect. This protective effect persisted in subgroup analysis of colorectal surgery patients and the use of Impact.
KW - General surgery
KW - Nutrition
KW - Surgery
KW - Surgical site infection
UR - http://www.scopus.com/inward/record.url?scp=85163876232&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.amjsurg.2023.06.011
DO - https://doi.org/10.1016/j.amjsurg.2023.06.011
M3 - Review article
C2 - 37385857
SN - 0002-9610
VL - 226
SP - 330
EP - 339
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 3
ER -