Key result
Preoperative protein inadequacy (<1.2 g/kg ideal body weight) significantly increased the risk of post-elective laparotomy surgical site infection compared to adequate intake (RR 3.413).
Why the study?
Preoperative protein intake increases muscle reserves and supports healing, but its association with surgical site infections following elective laparotomy required analysis.
Does preoperative protein adequacy reduce surgical site infection in patients undergoing elective laparotomy?
Cohort (n=93)
No
Does preoperative protein adequacy reduce surgical site infection in patients undergoing elective laparotomy?
Preoperative protein adequacy and albumin levels are strongly predictive of surgical site infections following elective laparotomy.
Protein inadequacy associated with higher SSI risk after laparotomy; leaves open whether preoperative optimization reduces infections.
Background/Aims: Postoperative complications tend to occur in high-risk populations, including those undergoing major surgery. Surgical site infections (SSI) are some of the most common postoperative complications in laparotomy procedures. Surgery induces a postoperative stress response, triggering an inflammatory process that increases muscle protein proteolysis. Preoperative protein intake increases muscle protein reserves and supports postoperative wound healing and immunity. This study analyzed the association between preoperative protein adequacy and post-elective laparotomy SSI. Methods: A prospective cohort study was conducted on 93 subjects with an adequate protein group of 48 subjects and an inadequate protein group of 45 subjects undergoing elective laparotomy at Dr. Cipto Mangunkusumo Hospital, Jakarta. The protein adequacy was analyzed using an interview method for seven days preoperatively. Patient monitoring was carried out for 30 days postoperatively to assess the complications in the form of SSIs. The association between protein adequacy and SSI was analyzed using a Chi-Square test, and multivariate analysis was performed to assess the factors most associated with post-elective laparotomy SSI. Results: An association was observed between preoperative protein adequacy and post-elective laparotomy SSI (RR 3.413; 95% CI, 1.363-8.549; p=0.004). Multivariate analysis showed that the preoperative protein adequacy and preoperative albumin levels were strongly predictive of the occurrence of SSI. Conclusions: The preoperative protein adequacy and albumin levels were strongly related to predicting the post-elective laparotomy SSI.
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Muhamad et al. (2023) conducted a cohort in Elective laparotomy (n=93). Preoperative protein inadequacy (<1.2 g/kg ideal body weight) vs. Adequate preoperative protein intake (≥1.2 g/kg ideal body weight) was evaluated on Post-elective laparotomy surgical site infection (SSI) (RR 3.413, 95% CI 1.363-8.549, p=0.004). Preoperative protein inadequacy (<1.2 g/kg ideal body weight) significantly increased the risk of post-elective laparotomy surgical site infection compared to adequate intake (RR 3.413).
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