Nutrition and the Plastic Surgeon: Possible Interventions and Practice Considerations

The objective of this article is to convey the importance of nutrition in plastic surgery, to offer possible outpatient nutritional interventions within the surgical care setting, and to guide the plastic surgeon in integrating nutrition as a key practice enhancement strategy for the care of wound patients and beyond. The impact of nutritional status on surgical outcomes is well recognized. Malnutrition is very frequent among the hospitalized patient population and up to 1 in 4 plastic surgery outpatient is at risk for malnutrition. Micro- and macronutrients are both essential for optimal wound healing and although specific patient populations within the field of plastic surgery are more at risk of malnutrition, universal screening, and actions should be implemented. Outpatient interventions to promote adequate nutritional intake and address barriers to the access of fruits and vegetables have included both exposure and incentive interventions. In the clinical setting, universal screening using validated and rapid tools such as the Canadian Nutritional Screening Tool are encouraged. Such screening should be complemented by appropriate blood work, body mass index measurements, and prompt referral to a dietician when appropriate. The notion of prehabilitation has also emerged with impetus in surgery and encompasses the nutritional optimization of patients by promoting the enhancement of functional capacity preoperatively.