SURGERY IN THE STARVED

The nutritional status of surgical patients is crucial, it
affects the post operative recovery,wound healing, convelecsence
and final outcome of the procedure.It is important to assess
the status and correctional action be taken.



4.1 Assessment of nutrition status
The nutritional status may be assessed during general physical
examination and the criteria include :

- Body weight ( compared to ideal for height and age)
- Mid-arm muscle circumference (MUMC)
- Skin fold thickness
- Muscle grip

Nutritional status may also be assessed by investigations:

- Lymphocyte count
- Serum Albumin
- Transferrin levels
- Thyroxine binding pre-albumin

The confirmation of this can be obtained if there has been recent
weight loss of more than 10%.

A body weight less than 80% of ideal for height

- Serum albumin less than 30 gm/l
- Total lymphocyte count below 1.2 x 109/l
- Mid upper arm circumference (MUAC) correlates with BMI cut of 23 cm male & 22 cm females


4.2 Clinical Conditions
The major causes of inadequate intake are the disorders
leading to less than 50% intake of calorie requirements 7-10days
Underlying causes
- Severe dysphagia in the unconscious i.e Head injury, stroke
- Major full thickness burns
- Major Trauma
- Radiation
- Chemotherapy
Any questions be sent to drmmkapur@gmail.com
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