Korean Journal of Community Nutrition (대한지역사회영양학회지)

The Korean Society of Community Nutrition (대한지역사회영양학회)
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Impact of postoperative dietary types on nutrition and treatment prognosis in hospitalized patients undergoing oral and maxillofacial surgery: a comparative study

  • Sung Bin Youn (Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Se-Hui Ahn (Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Dong-Ho Cho (Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Hoon Myoung (Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University)
  • Received : 2024.02.02
  • Accepted : 2024.04.16
  • Published : 2024.04.30
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Abstract

Objectives: The objective of this study is to compare a nutritionally balanced soft blend diet (SBD) with a soft fluid diet (SFD) on the health of inpatients who have undergone oral and maxillofacial (OMF) surgery, ultimately aiming to enhance care outcomes, improve health-related quality of life (QOL), and increase satisfaction with the hospital. Methods: Thirty-two patients were randomized into two groups: sixteen received SFD and sixteen received SBD. Anthropometric, laboratory evaluations were conducted upon admission and discharge. Patients filled out questionnaires on demographics, diet satisfaction, food intake amount, and health-related QOL on the day of discharge, assessed using the EuroQoL 5 Dimensions 3 Level and EuroQoL Visual Analogue Scale (EQ-VAS) instruments. Data were analyzed with descriptive statistics, χ2 tests for group differences, and paired nonparametric t-tests for within-group comparisons. The Mann-Whitney U test evaluated inter-group differences in preoperative weight and body mass index (BMI), postoperative changes, meal satisfaction, intake, health-related QOL, and self-assessed health status. P-values were set at a significance level of 0.05. Results: The SBD group had higher dietary intake (63.2% vs. 51.0%) and greater diet satisfaction (80.6 vs. 48.1, P < 0.0001) compared to SFD group. Health-related QOL, measured by EQ-VAS, was better in SBD group (70.3 vs. 58.8, P < 0.05). Postoperative weight and BMI decreased in SFD group but increased in SBD group (P < 0.01). Changes in laboratory results showed more stability in the SBD group. No postoperative infections were reported in SBD group, whereas SFD group had a 31.25% complication rate. Conclusions: While SFD is often recommended after OMF surgery to protect oral wound healing process, our study reveals that SBD not only enhances physical and psychological outcomes but also, somewhat unexpectedly, supports wound healing and reduces complications. Essentially, SBD promotes physical recovery and enhances health-related QOL than SFD by supporting both somatic and mental healing aspects.

Keywords

Acknowledgement

The authors would like to thank the patient, who allowed us to report this clinical case.

References

  1. Giridhar VU. Role of nutrition in oral and maxillofacial surgery patients. Natl J Maxillofac Surg 2016; 7(1): 3-9. https://doi.org/10.4103/0975-5950.196146
  2. Hebuterne X, Lemarie E, Michallet M, de Montreuil CB, Schneider SM, Goldwasser F. Prevalence of malnutrition and current use of nutrition support in patients with cancer. JPEN J Parenter Enteral Nutr 2014; 38(2): 196-204. https://doi.org/10.1177/0148607113502674
  3. Mahat AK, Panta N, Shrewastwa MK, Puri R, Basnet LB. Short and long term impact on oral health related quality of life after maxillofacial trauma. J Nepal Health Res Counc 2023; 21(1): 76-80. https://doi.org/10.33314/jnhrc.v21i1.4532
  4. Soh CL, Tan PG, Mohd Nor N. Oral health related quality of life after treatment in maxillofacial trauma patients. J Oral Maxillofac Surg Med Pathol 2021; 33(3): 267-271. https://doi.org/10.1016/j.ajoms.2020.12.013
  5. Qian SJ, Liu B, Shi J, Zhang X, Deng K, Shen J, et al. Effects of dental implants and nutrition on elderly edentulous subjects: protocol for a factorial randomized clinical trial. Front Nutr 2022; 9: 930023.
  6. Beluci ML, de Barros SP, Borgo HC, Fontes CM, Arena EP. Postsurgical alveolar bone graft patients: elaboration and application of a data-gathering instrument for nutrition and nursing. Cleft Palate Craniofac J 2014; 51(2): 172-177.  https://doi.org/10.1597/11-278r
  7. Obayemi A Jr, Tatum SA. Enhanced Recovery after Surgery (ERAS) protocols in craniomaxillofacial surgery: an evidence-based review. Curr Opin Otolaryngol Head Neck Surg 2022; 30(4): 265-269. https://doi.org/10.1097/MOO.0000000000000813
  8. Ludwig DC, Huang K, Lynch S, Koceja L, Tressel W, Dillon JK. What is the role of nutrition counseling in the management of isolated mandible fractures? Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128(5): 464-471. https://doi.org/10.1016/j.oooo.2018.12.005
  9. Kehlet H. ERAS implementation-time to move forward. Ann Surg 2018; 267(6): 998-999. https://doi.org/10.1097/SLA.0000000000002720
  10. Cziperle DJ, Avitene TM. Avitene™ microfibrillar collagen hemostat for adjunctive hemostasis in surgical procedures: a systematic literature review. Med Devices (Auckl) 2021; 14: 155-163.
  11. Hush SE, Chen JT, Brady CM, Soldanska M, Nusz DJ, Rhinehart DL, et al. Implementation of a modified enhanced recovery protocol in cleft palate repairs. J Craniofac Surg 2019; 30(7): 2154-2158. https://doi.org/10.1097/SCS.0000000000005718
  12. Deo PN, Deshmukh R. Oral microbiome: unveiling the fundamentals. J Oral Maxillofac Pathol 2019; 23(1): 122-128. https://doi.org/10.4103/jomfp.JOMFP_304_18
  13. Mioton LM, Jordan SW, Hanwright PJ, Bilimoria KY, Kim JY. The relationship between preoperative wound classification and postoperative infection: a multi-institutional analysis of 15,289 patients. Arch Plast Surg 2013; 40(5): 522-529. https://doi.org/10.5999/aps.2013.40.5.522
  14. McCaffrey N, Kaambwa B, Currow DC, Ratcliffe J. Health-related quality of life measured using the EQ-5D-5L: South Australian population norms. Health Qual Life Outcomes 2016; 14(1): 133.
  15. Feng Y, Parkin D, Devlin NJ. Assessing the performance of the EQ-VAS in the NHS PROMs programme. Qual Life Res 2014; 23(3): 977-989. https://doi.org/10.1007/s11136-013-0537-z
  16. Buzby GP, Mullen JL, Matthews DC, Hobbs CL, Rosato EF. Prognostic nutritional index in gastrointestinal surgery. Am J Surg 1980; 139(1): 160-167. https://doi.org/10.1016/0002-9610(80)90246-9
  17. Hua X, Long ZQ, Huang X, Deng JP, He ZY, Guo L, et al. The value of prognostic nutritional index (PNI) in predicting survival and guiding radiotherapy of patients with T1-2N1 breast cancer. Front Oncol 2020; 9: 1562.
  18. Heys SD, Walker LG, Eremin O. The value of peri-operative nutrition in the sick patient. Proc Nutr Soc 1997; 56: 443-457. https://doi.org/10.1079/PNS19970045
  19. Sanchez-Ayala A, Lagravere MO, Goncalves TM, Lucena SC, Barbosa CM. Nutritional effects of implant therapy in edentulous patients--a systematic review. Implant Dent 2010; 19(3): 196-207. https://doi.org/10.1097/ID.0b013e3181d46903
  20. Kyle UG, Genton L, Pichard C. Hospital length of stay and nutritional status. Curr Opin Clin Nutr Metab Care 2005; 8(4): 397-402. https://doi.org/10.1097/01.mco.0000172579.94513.db
  21. Schneider J, Peterli R, Gass M, Slawik M, Peters T, Wolnerhanssen BK. Laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass lead to equal changes in body composition and energy metabolism 17 months postoperatively: a prospective randomized trial. Surg Obes Relat Dis 2016; 12(3): 563-570. https://doi.org/10.1016/j.soard.2015.07.002
  22. Kuvat SV, Guven E, Hocaoglu E, Basaran K, Marsan G, Cura N, et al. Body fat composition and weight changes after double-jaw osteotomy. J Craniofac Surg 2010; 21(5): 1516-1518. https://doi.org/10.1097/SCS.0b013e3181f03fb3
  23. Vellas B, Guigoz Y, Garry PJ, Nourhashemi F, Bennahum D, Lauque S, et al. The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition 1999; 15(2): 116-122. https://doi.org/10.1016/S0899-9007(98)00171-3
  24. Hannan JL, Radwany SM, Albanese T. In-hospital mortality in patients older than 60 years with very low albumin levels. J Pain Symptom Manage 2012; 43(3): 631-637. https://doi.org/10.1016/j.jpainsymman.2011.04.009
  25. Friedman AN, Fadem SZ. Reassessment of albumin as a nutritional marker in kidney disease. J Am Soc Nephrol 2010; 21(2): 223-230. https://doi.org/10.1681/ASN.2009020213
  26. Galata C, Busse L, Birgin E, Weiss C, Hardt J, Reissfelder C, et al. Role of albumin as a nutritional and prognostic marker in elective intestinal surgery. Can J Gastroenterol Hepatol 2020; 2020: 7028216.
  27. Cabrerizo S, Cuadras D, Gomez-Busto F, Artaza-Artabe I, Marin-Ciancas F, Malafarina V. Serum albumin and health in older people: review and meta analysis. Maturitas 2015; 81(1): 17-27. https://doi.org/10.1016/j.maturitas.2015.02.009
  28. Okadome K, Baba Y, Yagi T, Kiyozumi Y, Ishimoto T, Iwatsuki M, et al. Prognostic nutritional index, tumor-infiltrating lymphocytes, and prognosis in patients with esophageal cancer. Ann Surg 2020; 271(4): 693-700. https://doi.org/10.1097/SLA.0000000000002985
  29. Safak O, Yildirim T, Emren V, Avci E, Argan O, Aktas Z, et al. Prognostic nutritional index as a predictor of no-reflow occurrence in patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention. Angiology 2023; 33197231193223.