NUTRITION & RECOVERY PROTOCOL
Your body does the healing. Our job is to give it the tools it needs to do that well.
Excellent surgical care is about more than the operation itself. Before and after surgery, we focus on nutrition, strength, hydration, movement, and the individual needs of each patient to help support a smooth recovery.
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PROTOCOL FOR EVERY PATIENT
Start 7–14 Days Before Surgery
Protein — The Foundation
- Target at least 0.5 grams of protein per pound of body weight per day
- For many patients, this will be approximately 80–120 grams of protein per day
- Prioritize high-quality protein at every meal.
- Use a complete protein supplement when dietary intake is inadequate.
Why protein matters: Protein provides the amino acids your body needs to repair tissue, support immune function, and maintain muscle during recovery.
Daily Nutritional Support – Added Insurance
Pure Encapsulations O.N.E. Multivitamin – Provides a broad range of vitamins and minerals to help support overall nutritional needs.
- 1 capsule daily with food
Pure Encapsulations Buffered Ascorbic Acid (Vitamin C that can be gentler on the stomach) – Vitamin C plays an important role in collagen production and normal tissue repair.
- 1 capsule twice daily
Pure Encapsulations Zinc 15 – Zinc supports normal immune function and tissue repair.
- 1 capsule daily with food
Optimize Nutrition Before Surgery
When clinically appropriate, identify and address nutritional deficiencies, including:
- Iron
- Vitamin B12
- Folate
- Vitamin D
- Other clinically significant deficiencies
Patients with significant weight loss, poor intake, sarcopenia, frailty, or suspected malnutrition may require additional nutritional assessment.
Lifestyle Optimization
- Avoid nicotine and tobacco.
- Optimize blood glucose.
- Maintain adequate hydration.
- Maintain appropriate physical activity and resistance exercise when possible.
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Postoperative Days 0–28
Protein
Continue 0.5 grams of protein per pound of body weight per day
Make protein a priority even when appetite is reduced.
Nutrition
- Resume oral nutrition as soon as clinically appropriate.
- Follow your procedure-specific diet.
- Foregut patients should advance their diet according to their surgical instructions.
- Bariatric patients should follow their separate bariatric nutrition pathway.
Supplements
Continue:
- O.N.E. Multivitamin: 1 daily with food
- Pure Encapsulations Buffered Ascorbic Acid: 500 mg twice daily
- Zinc 15: 15 mg daily
HYDRATE & MOVE
Stay hydrated
Adequate fluids help support normal body function and recovery.
Move early and often
Walking and gradually increasing activity are important parts of recovery. We’ll provide specific activity instructions based on your procedure.
Follow your surgical diet
Especially after foregut or bariatric surgery, your diet will progress according to your individual recovery plan.
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ENHANCED HEALING PROTOCOL FOR HIGHER-RISK PATIENTS
The enhanced protocol may be appropriate for patients undergoing:
Complex Abdominal Wall Surgery
- Large ventral or incisional hernia repair
- Recurrent hernia repair
- Major abdominal wall reconstruction
Major Foregut Surgery
Other Risk Factors:
- Major foregut reconstruction
- Significant preoperative weight loss
- Poor oral intake
- Sarcopenia or frailty
- Increased nutritional risk
We May Also Need to Add Specialized Immunonutrition:
For selected patients, consider a commercial surgical immunonutrition formula containing:
Arginine + omega-3 fatty acids + nucleotides
Example: IMPACT®
The rationale is important: the surgical evidence is primarily for this combination of nutrients, rather than for isolated arginine supplementation.
Typical approach: Begin approximately 5–7 days before surgery and continue through the early postoperative period according to the current product labeling and clinical protocol.
Do not routinely add standalone L-arginine on top of immunonutrition.
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Consider additional nutritional assessment or dietitian referral for patients with:
- Significant unintentional weight loss
- Inadequate protein intake
- Sarcopenia
- Frailty
- Malnutrition
- Significant micronutrient deficiencies
- Prolonged poor oral intake
The goal:
Correct the nutritional problem—not simply add more supplements.
Adequate protein and calories remain the foundation of recovery.
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Bariatric patients should follow a separate bariatric-specific nutritional protocol.
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WHAT WE ARE TRYING TO ACCOMPLISH
| Goal | Strategy |
| Maintain muscle | Adequate protein |
| Support tissue repair | Protein + vitamin C |
| Support immune function | Protein + zinc |
| Correct deficiencies | Individualized supplementation |
| Support higher-risk patients | Arginine + omega-3 + nucleotide immunonutrition |
| Maintain hydration | Adequate fluids |
| Promote recovery | Early nutrition + mobility |
| Reduce avoidable risk | Glycemic and nicotine optimization |
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There is no one-size-fits-all approach to recovery.
Your nutritional needs may vary based on your:
- Procedure
- Body composition
- Diet
- Activity level
- Medical history
- Nutritional status
If we identify nutritional concerns before surgery, we may recommend additional testing, dietary changes, or consultation with a nutrition professional.
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Your body does the healing.
We’re here to help you optimize it.
Expertise. Precision. Personalized Care.
Dr. Todd Worley 