Abstract
BackgroundSurgical site infections (SSIs) are among the most common healthcare-associated infections. Under-nutrition is an important risk factor for SSIs and can lead to delayed wound healing and longer hospital stays. Oral nutritional supplements are prescribed to reduce the risk of infection and improve health status, but data from randomised controlled trials (RCTs) have shown mixed results. Thus, the objective of our planned systematic review is to evaluate oral nutritional supplements on preventing SSIs in adult surgical patientsMethodsRCTs conducted in adult surgical patients who receive oral nutritional support will be included. The primary outcome will be the incidence of SSIs (within 30 days of surgery or within 90 days for joint replacement surgery). Secondary outcomes will be changes in nutritional status, mortality, health-related quality of life and costs. Literature searches will be conducted in several electronic databases (from inception onwards): MEDLINE, Embase, CINAHL and The Cochrane Central Register of Controlled Trials (CENTRAL). Grey literature will be identified through searching clinical trial registers and dissertation databases. Two reviewers will independently screen all citations, full-text articles and abstract data. The study methodological quality (or bias) will be appraised using the Cochrane risk of bias tool. If feasible, we will conduct random effects meta-analysis where appropriate.DiscussionThis systematic review will evaluate the evidence for pre- and post-surgical intervention with oral nutritional supplements in adults. Findings from this planned review may inform subsequent nutritional interventions for hospitalised patients who undergo surgery.Systematic review registrationPROSPERO CRD42020140954
Highlights
Surgical site infections (SSIs) are among the most common healthcare-associated infections
Findings reported from randomised controlled trials (RCTs) of oral nutritional supplementation have been mixed across studies of both single and multi-nutrient oral nutritional supplements
For studies investigating the effect of single-nutrient oral nutritional supplementation with a formula of either protein, arginine or amino acids, a reduced rate of postoperative infection complications was reported among head and neck cancer surgery patients but the effect was not statistically significant [49, 50]
Summary
Surgical site infections (SSIs) are among the most common healthcare-associated infections. Undernutrition is an important risk factor for SSIs and can lead to delayed wound healing and longer hospital stays. Surgical site infections (SSIs) are defined by the Centers for Disease Control and Prevention (CDC) as infections that occur after surgery in the part of the body or the incision where the surgery took place. SSIs result in delayed wound healing, increased hospital stays, increased use of antibiotics, unnecessary pain and, in extreme cases, death of the patient [9]. SSIs result in delayed wound healing, increased hospital stays, increased use of antibiotics, unnecessary pain, death of the patient in extreme cases, as well as increased health resource use and expenditure depending of the location, depth and severity of the infection [10, 11]. Hospitalisation is associated with a deterioration of nutritional intake in admitted elective surgical patients leading to under-nutrition [17]
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