Every day when I go to the clinical ward, I meet different patients and family members in different surgical departments who are concerned about what they can eat after surgery and what they can eat to make the wound heal faster. Can I eat this and that from my friends and relatives? Today, I will give you answers to 8 questions related to post-operative nutrition. 1.Why do patients need special nutritional support after surgery? Normal people need a certain amount of energy and nutrients every day to maintain normal metabolism, not to mention the huge consumption of surgery. Pre-operative fasting, various examinations and operations, intra-operative blood loss, various invasive operations, post-operative wound pain, loss of body fluids, etc. will all cause an increase in energy consumption compared to normal. The postoperative inflammatory response and wound healing will also consume more energy and nutrients. Not to mention that if the patient develops complications such as infections, gastrointestinal fistulas, etc., the patient will be more likely to have a higher energy expenditure than usual. With prolonged fasting or almost fasting, the reserves of various nutrients are quietly depleted. As a result, we will see that the patient is losing weight day by day, and his face is not as rosy as it used to be, and he looks weak and feeble. 2.Can I drink chicken soup and fish soup to help my recovery? This is one of the most common questions asked by patients and their families after surgery. The answer is no. You should eat chicken, fish and other foods containing high quality protein to replenish the energy and protein needed by the body. Chicken and fish soups are traditionally thought to be nutritious and “long wounded”. In fact, although chicken and fish soups are stewed for a period of time, the main nutrient, protein, is not released into the soup. The main presence in the soup is the purines, seasonings, fats and oils of these meat foods, but of course with the length of time the soup is simmered, there are varying degrees of amino acids dissolved in the soup. Compared to chicken and fish, the value of the soup is not as high as one might think. It is especially worth mentioning that the creamy soup is not more nutritious either. Many patients’ families say that they need to make fish soup milky white to make it ‘most nutritious’. Anyone who has stewed fish soup knows that if you throw raw fish into the water and stew it, it will not appear “milky white” anyway. If you want to get the ideal soup color, you have to fry the fish in oil on both sides beforehand to achieve the effect. In fact, the creamy soup is the result of fat emulsification. 3.What exactly can I eat to help my recovery? If only the surgery is done and the patient himself does not have liver disease or kidney disease, the dietitian will usually start gradually with an unbalanced liquid and semi-liquid diet (thin rice, noodles, etc.) and gradually progress to a balanced diet. By balanced, it means a whole nutrient diet with protein (amino acids), carbohydrates and fats in a certain ratio. In particular, many patients and families like to magnify the role of protein, such as the use of protein powder or high-protein nutrition powder, and so on. There is a prerequisite for such use, that is, the patient’s energy supply should be comprehensive and adequate. Adequate means that the amount of each nutrient should be sufficient to meet the patient’s needs. To put it simply, if you have started to eat three meals normally, you should eat enough staple foods such as rice and noodles, and natural foods with high protein such as eggs, milk or dairy products should also be consumed. If the total energy supplement is not enough, even more protein powder will not help, but will increase the burden on the kidneys. 4. Is protein powder good for wound healing? Patients and families are not the only ones who believe in protein powder. Is protein powder helpful for wound healing? The answer is, yes, but it should not be superstitiously used. It is true that protein has a major and irreplaceable importance for tissue repair. But protein powder’s is the ‘icing on the cake’, not the ‘snow on the cake’. In other words, if the patient does not eat enough energy, then drinking protein powder will not help and will be wasted; if the energy supply is reasonable and sufficient, protein powder is useful as a beneficial supplement to protein. Patients should confirm their kidney function with their doctor or dietitian before using protein powder, and if they already have kidney damage, they should use less or not use it. There are many types of protein powders, but the main ones that are used frequently are protein powder preparations made of soy protein and whey protein with higher purity. Soy protein is not recommended for patients with a history of gout, while whey protein powder is more widely used by people with no contraindications. In the time of brewing drinking, avoid boiling water, it is best to use warm and cool boiling water. 5.Will eating soy sauce leave scars? No, it will not. Let’s first understand about soy sauce. Soy sauce with raw materials is plant protein and starchy raw materials, raw materials by steaming and cooling, access to pure culture of Aspergillus species made of soy sauce, soy sauce moved into the fermenter, add salt and water fermentation, to be matured soy sauce spirits, to extract soy sauce leaching method. In the process after that the proteins decomposed by the bacteria into amino acids, amino acids in the oxidation process, as well as the reaction process with starchy substances will produce black material, which is the source of soy sauce red and black. The main nutritional components of soy sauce include amino acids, soluble proteins, sugars, acids, etc. After soy sauce is made into a dish as a cooking ingredient and is eaten into the belly, it does not gather directly to the wound, but has to undergo further decomposition and processing in the large chemical factory of the gastrointestinal tract. The pigment and other substances are then metabolized and decomposed in the liver. In addition, the dark spots or darker skin we see everyday are caused by the skin’s normal defense against UV rays, mainly related to tyrosine activity and the number and synthetic energy of our own melanocytes. 6.When do I start “eating”? Every morning when the doctor checks in, the first few words will be asking the patient about his or her diet. For example, if a patient is just two days post-operative, the doctor will ask “are you hungry” and “have you farted” and so on. Don’t underestimate these two simple questions, but they are the condensation of “science”. The patient’s subjective “hunger” is often a sign of recovery of gastric power, while “is there gas” is a sign of recovery of intestinal power. It is the patient’s own body that “decides” exactly when to start eating. Although many foreign textbooks advance the time to start early enteral nutrition to within 48-72 hours after surgery, in practice, we found that most patients do not have a “macroscopic” recovery of gastrointestinal motility, even if they are fed with various kinds of nutrition, they often do not have a particularly good effect. Therefore, in order to maintain and protect the function of the gastrointestinal tract on the one hand, and not to add too much digestive burden to the patient’s unrecovered gastrointestinal tract on the other hand, we clinically start with “non-burdensome food” such as saline, sugar saline and rice soup. Even if the patient does not really start eating on his own, the doctor will ensure the patient’s nutrition by other means. 7. Why can’t some patients eat directly after surgery? The answer is that it depends on the situation. For example, for patients undergoing orthopedic surgery, especially those with fractures of the limbs or joints, if there are no factors that would affect eating or no special positions, you can slowly resume eating “from little to much, from thin to dry” while the patient is conscious after anesthesia. After all, the gastrointestinal tract has not been working at full capacity before and during surgery, and it takes time to adapt to the new duty. However, for patients undergoing pharyngeal surgery (swallowing requires the cooperation of the muscles in the mouth and the muscles in the throat), gastrointestinal surgery (the gastrointestinal tract needs rest), or cranial surgery (the patient may not regain consciousness temporarily, and even if he or she does, stress ulcers may occur), the dietitian will work with the doctor to prescribe different nutritional treatment plans according to the patient’s actual condition, which makes the simple “eating” process This makes the simple process of “eating” scientific and complex. 8.What kind of problems will arise during the process of “eating”? If the dietitian feels that the patient’s digestive function has not reached the level where he/she can eat on his/her own, enteral nutrition may be given through nasogastric tube or nasogastric tube. Once the enteral nutrition solution has been successfully dosed to the patient’s target therapeutic level, the dietitian will often begin to recommend a “trial meal”. A “trial meal” is a trial meal. From pre-op to intra-op to post-op, it has been a long time since the patient has chewed on the natural food he or she has missed for so long! However, even familiar foods need to be slowly tried, transitioned and accumulated from the simplest thin rice, soft noodles, buns, milk, eggs, etc. In addition, special clinical attention needs to be paid to the supplementation of various water and fat soluble vitamins own minerals, such as vitamin C, potassium, magnesium, etc. Only when you add one or several foods without discomfort or adverse reactions can you be considered to have successfully marched to the “final victory”. If you can eat natural foods on your own, you are not far from a full recovery from the hospital!