Surgical malnutrition

Surgical malnutrition can present in a variety scenarios:

• preoperative malnutrition, a range of states of protein-energy malnutrition that may be due to:
  • insufficient food supply
  • dysphagia
  • defective absorption
  • increased rate of catabolism e.g. malignancy
• postoperative malnutrition:
  • acute starvation
  • prolonged fasting
  • hypercatabolic state - a resting metabolic rate increased by more than 25% - secondary to:
    • sepsis
    • trauma e.g. operation, burns

The two extremes are a marasmus-like state with loss of both muscle and fat deposits, and a kwashiokor-like state with a disproportionate loss of muscle protein stores.

Careful assessment of the surgical patient is needed when malnutrition is suspected as nutritional support may be indicated. Clinically relevant malnutrition is that associated with physiological impairment.