IMPROVING OUTCOMES AND RECOVERY AFTER SURGERY AND INJURY Over the last decade a substantial amount of research has been completed aimed at reducing perioperative stress, maintaining postoperative function and accelerating recovery after surgery. In many types of surgeries, the use of a multi-pronged approach to reduce surgical stress has been shown repeatedly to decrease rates of complications, improve recovery and shorten hospital length of stay. PREOPERATIVE STRATEGIES Smoking – It is well known that the risk of postoperative complications is greater in patients who smoke. In particular, infections and wound, lung, and brain complications are more common in patients who smoke. While smoking cessation for at least 4 weeks is ideal for reducing lung and wound-healing complications, shorter periods prior to surgery may still be beneficial but not to the same degree. After 8 weeks of smoking cessation, the risk is similar to those who have never smoked. Alcohol abuse – Surgical patients who consume over 4 drinks daily have a 2-3 fold increased risk for postoperative complications (heart, lung infection, wound healing, bleeding and brain) compared to patients who consume less than 2 drinks daily. Preoperative abstinence from alcohol is recommended to reduce postoperative complications but the evidence to support this recommendation is weaker. The duration of abstinence required to reduce alcohol ’s negative effects varies from 2-8 weeks depending on the organ (e.g. heart vs brain vs liver). [5]
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