Study of articles: Importance of diet in the pre and post-operative period in oral and maxillofacial surgeries

 In major and minor oral surgeries, there are three stages: preoperative, intraoperative, and postoperative (before, during, and after the procedure, respectively). Often, the most significant complications occur during the postoperative phase, including localized and diffuse pain, swelling, bruising, hyper and hypoglycemic episodes, lowered immunity, and, in extreme cases of neglect, patients may suffer from malnutrition, and, later on, fatal consequences. With this in mind, the quicker and less painful the healing process of intentional traumas caused by oral and maxillofacial surgeries, the better the patient's recovery.

A suitable, nutritious diet with proper professional guidance can reduce healing time and contribute to postoperative success. This is possible because of cellular repair processes, which work better with a source of proteins and amino acids, the major building blocks for lesion repair. Carbohydrates are also necessary as a primary source of glucose, providing energy to cells for tissue repair metabolic reactions. Vitamin A primarily acts during the inflammatory phase of healing, while vitamin K is essential for blood clotting and bone metabolism. A balanced diet, including all vitamins, macro and micronutrients, is essential for these processes to occur and is of great importance for the patient's faster recovery.

It is important to note specific cases where patients cannot adapt to a liquid diet or have impaired chewing and swallowing functions due to recent surgical trauma. For such cases, nutritional supplementation through parenteral routes like intravenous, and enteral routes like liquid diet or, in severe cases, the use of nasogastric, nasoduodenal, and nasojejunal tubes is well-accepted, with each option suitable for specific patient comorbidities. It has been proven that in cases of mid-face and mandibular fractures, basal metabolism accelerates by 10%. Therefore, the increased risk of rapid weight loss and malnutrition due to delayed healing becomes a greater factor of morbidity for patients in these conditions, who should be referred to a nutrition professional for monitoring.

Nutrition counseling for patients undergoing oral and maxillofacial surgeries does not greatly impact the advised weight loss or gain. However, it does affect the number of postoperative complications. Studies have concluded that patients advised by nutrition professionals had fewer complications and a faster recovery.

In many mid-face and mandibular surgeries, intermaxillary immobilization is necessary to fix the occlusion in its proper place and aid in bone repair. It also facilitates the intraoperative process in mandibular fractures. This immobilization prevents the patient from opening their mouth to consume solid foods, but liquid foods are still viable.

Therefore, nutritional monitoring in the preoperative and postoperative phases is crucial. The entire process of healing and tissue repair depends on vitamins and macro and micronutrients consumed before and after the surgical procedures in question, all aimed at achieving faster improvement and greater patient well-being."

References:

Ruslin, M., Dekker, H., Tuinzing, D., & Forouzanfar, T. (2017). Assessing the need for a weight loss and nutritional status monitoring protocol in orthognathic surgery based on patient experiences. Journal of Clinical and Experimental Dentistry, 0–0.

Falender, LG, Leban, SG, & Williams, FA (1987). Postoperative nutritional support in oral and maxillofacial surgery. Journal of Oral and Maxillofacial Surgery

Ludwig, DC, Huang, K., Lynch, S., Koceja, L., Tressel, W., & Dillon, JK (2018). What is the role of nutritional counseling in the treatment of isolated mandibular fractures? Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology

Braidy, H., Ziccardi, VB, Phillips, W., & Willcutts, K. (2014). Oral Surgery, Diet, and Nutrition. Nutrition and Oral Medicine

Katherine L. Brown MD, Tânia J. Phillips MD, FRCPC Department of Dermatology, Boston University School of Medicine, 609 Albany St, Boston MA 02118, USA