Perioperative nutritional supplementation to reduce postoperative infections: a systematic review and meta-analysis
Abstract
Introduction
Postoperative infections, including surgical site infections (SSIs), pneumonia, bloodstream infections (BSIs), and urinary tract infections (UTIs), remain among the most frequent and impactful complications following surgery. They contribute substantially to patient morbidity, length of stay, and healthcare costs, despite improvements in surgical techniques and perioperative care. In Europe alone, healthcare-associated infections are estimated to cause over 90,000 deaths annually and impose a burden of more than 500 DALYs per 100,000 population [1]. Despite the adoption of ERAS protocols and prophylactic antibiotics, the incidence of postoperative infections has plateaued in many settings, suggesting the need for adjunctive strategies beyond standard perioperative care. In this context, perioperative nutrition has emerged as a potentially modifiable factor capable of influencing immune responses, gut microbiota, and systemic inflammation. Immunonutrition (enriched with arginine, omega-3 fatty acids, nucleotides), probiotics, synbiotics, and protein supplementation are currently being investigated for their ability to prevent infectious complications and improve surgical outcomes [2,3]. However, the literature is fragmented and results are often inconsistent across interventions and populations [4-7].
Objectives
This study aimed to systematically evaluate the efficacy of perioperative nutritional supplementation in reducing postoperative infectious complications…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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