The aim of this study was to investigate the effect of adding omega 3 and dipeptiven to standard feeding in head and neck patients who will undergo oral cavity tumour resection or mandibular tumour resection (immunonutrrition mixture) on wound infection, fistula formation and length of hospital stay ,total dose of intraoperative and postoperative opioids (opioid consumption and pain incidence ,mortality and other postoperative complications as urinary tract infection (UTI) and pneumonia.
Enhanced Recovery after Surgery (ERAS). A series of components that combine to minimize stress and to facilitate the return of function have been described: these include preoperative preparation and medication, fluid balance, anesthesia and postoperative analgesia, pre- and postoperative nutrition, and mobilization. Nutrition therapy is the provision of nutrition or nutrients either orally (regular diet, therapeutic diet, e.g. fortified food, oral nutritional supplements) or via enteral nutrition (EN) or parenteral nutrition (PN) to prevent or treat malnutrition. Head and neck cancer surgery usually means surgery to treat cancer of the mouth, throat or larynx . The surgery is complicated and people often experience problems such as wound infections and wound breakdown, as well as infections such as pneumonia. The use of a nutritional supplement enriched with Omega 3 fatty acids is associated with a greater preoperative weight loss, reduced postoperative pain and decreased postoperative levels of C reactive protein in patients undergoing Roux-en-Y gastric bypass.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
DOUBLE
Enrollment
176
Patients received only standard feeding with caloric distribution (45%-50% carbohydrates,20\_35% from fats and 10-35% from protein)
Patients received perioperative supplementation with omega 3 and dipeptiven (immunonutrition mixture) plus standard feeding.
Cairo University
Cairo, Egypt
The incidence of wound infection
Evidence of redness and tenderness of surgical wound with discharge of pus was defined as a wound infection.
Time frame: 28 days after intervention
Fistula formation
Fistula formation was measured postoperatively.
Time frame: 28 days after intervention
Length of hospital stay
Length of hospital stay was measured from admission discharge from hospital
Time frame: 28 days after intervention
Total dose of intraoperative opioids
Total dose of intraoperative opioids was calculated in either group
Time frame: Intraoperative
Total dose of postoperative opioids
Total dose of postoperative opioids was calculated in either group
Time frame: 12 hours postoperative
Degree of pain
Postoperative pain will be assessed by visual analogue scale (VAS) every 4 h. for 12 h. Patients reporting VAS score (more than 3) will receive rescue analgesics. VAS (0 represents "no pain" while 10 represents "the worst pain imaginable").
Time frame: 12 hours postoperative
The incidence of mortality
Mortality was measured postoperatively
Time frame: 28 days after intervention
The incidence of complications
Postoperative complications as urinary tract infection (UTI)and pneumonia.
Time frame: 12 hours postoperative
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