protein supplements and dietary advice. For example, patients should
be advised to eat 65 grams to 100 grams of protein a day to build muscle
strength and boost the immune system. Fruits and vegetables help
repair muscle, bones and cartilage, and whole grains increase levels of
vitamin B, which repairs tissue and boosts the immune system.
"Patients must build up the body's reserves to prepare for the cata-
bolic insult of surgery," says Ms. Gillis. "Compromised reserves will
deteriorate quickly from the physical stress, resulting in muscle loss,
loss of strength and even impairment."
Patients can also drink carb-rich, pre-surgery drinks up to 2 hours
before procedures begin to help stimulate the body's cells that are
responsible for decreasing inflammation and promoting tissue repair.
"The drinks have been a positive development because patients are
hydrated and more comfortable — and happier — when they show up
for surgery," says Ms. Gillis. "Maintaining a glycogen reserve is essential
during the post-op recovery because it can attenuate protein catabolism
after surgery."
At-home skin prepping
Patients who bathe at home with Chlorhexidine gluconate (CHG) the
night before and morning of surgery are less likely to return home
with a surgical site infection. "There's a tremendous advantage of
using the pre-admission shower strategy to reduce the microbial bur-
den on the surface of the skin," says Charles E. Edmiston, PhD, CIC,
FIDSA, FSHEA, FAPIC, an epidemiologist and emeritus professor of
surgery at the Medical College of Wisconsin in Milwaukee.
Patients should apply 118 ml of 4% CHG during each shower, accord-
ing to Dr. Edmiston. "For it to be maximally effective, the concentra-
tion should be sufficient to inhibit or kill the traditional surgical wound
pathogens that may be present on the patient's skin," says Dr.
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