The preferred method of nutrition for surgical patients is early oral feeding (Weimann, et al., 2017) (Williams, Molinger, & Wischmeyer, 2019). The surgical procedure itself leads to metabolic alterations like the release of stress hormones and inflammation. It causes the breakdown of glycogen, fat and protein in order to provide the substrates for healing and the immune response (Gillis & Carli, 2015). The consequence of protein breakdown is a loss of muscle mass which is a short and long-term burden for functional recovery.
Nutritional therapy (incl. ONS and ETF) may provide the energy and building blocks for optimal healing. In the immediate postoperative phase, the catabolic response can probably only be minimally counteracted. However, for the longer recovery, nutritional support is a prerequisite (Weimann, et al., 2017). For a detailed guidance, the recent published ESPEN guideline on clinical nutrition in surgery can be used (Weimann, et al., 2017). Some of the most important points will be discussed below.
There was a strong consensus that oral nutritional intake should be continued after surgery without any interruption. If a patient cannot be fed directly via the enteral route, it would be recommended to start with parenteral nutrition. Nutritional powders, like S-core, are perfect to use in this patient group. There is no evidence yet that specific ingredients/formulas are more beneficial. Since a high percentage of patients admitted to the hospital are already malnourished or at risk for malnourishment, it becomes even more important to include the nutritional management as part of the treatment and even consider nutritional therapy before the surgery for a period of 7-14 days. It is recommended to start ONS administration before the surgery in the more at-risk patient group.