An important advance in surgery is the recognition of the relation of the patient's state of nutrition to his chances of withstanding the shock of operative procedures, of resisting postoperative infection, of achieving primary closure of operative wounds and of avoiding postoperative complications. Recently the concept of protein deficiency as an important factor in the complications of surgery has received increasing recognition.
Hoffman1 presented a critical review discussing the role of proteins and amino acids in surgery. Several circumstances may lead to a protein deficiency in the preoperative and postoperative surgical patient: (1) decreased dietary intake of protein as in famine, poverty, obstructive conditions in the gastrointestinal tract and repeated vomting; (2) decreased absorption of protein as in diarrheal states or ulcerative disease of the intestine and in conditions associated with diversion or absence of pancreatic juice or bile from the intestinal tract; (3) decreased formation of blood proteins
PROTEINS AND AMINO ACIDS IN SURGERY. JAMA. 1948;136(6):401-402. doi:10.1001/jama.1948.02890230041012