Estratégias nutricionais para otimização da cicatrização de feridas operatórias na pessoa idosa: revisão de escopo
DOI:
https://doi.org/10.36517/2175-6783.20262795980Palabras clave:
Nutrição do Idoso; Cicatrização; Suplementos Nutricionais; Ferida Cirúrgica.Resumen
Objetivo: mapear as estratégias nutricionais empregadas no processo de cicatrização de feridas cirúrgicas em pessoas idosas. Métodos: revisão de escopo realizada nas bases: MEDLINE via PubMed, CINAHL, LILACS, Web of Science, SCOPUS, EMBASE, nas fontes de literatura cinzenta: Google Scholar e ProQuest Dissertations & Theses, além da plataforma Consensus IA, sem restrição de tempo ou idioma. Resultados: dos 4.882 estudos identificados, seis atenderam aos critérios de elegibilidade, abordando estratégias nutricionais e cicatrização de feridas cirúrgicas em pessoas idosas. As fontes incluíram estudos primários e secundários, dissertações e teses. Foram excluídas pesquisas com uso de tecnologias não farmacológicas. As principais estratégias envolveram suplementação oral ou enteral com fórmulas hipercalóricas e hiperproteicas enriquecidas com micronutrientes essenciais e o uso de suplementação contendo imunonutrientes (arginina, ômega-3, glutamina e nucleotídeos). Conclusão: as intervenções nutricionais apresentaram potencial para reduzir complicações pós-operatórias e favorecer a cicatrização em pessoas idosas, embora a heterogeneidade metodológica dos estudos exija cautela na interpretação dos resultados. Contribuições para a prática: os achados reforçam a importância do planejamento individualizado e da elaboração de protocolos nutricionais direcionados ao público idoso.
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Referencias
1. World Health Organization. Ageing and health [Internet]. 2025 [cited Aug 25, 2025]. Available from: https://www.who.int/news-room/fact-sheets/detail/ageing-and-health
2. Presidência da República (BR). Lei nº 10.741, de 1º de outubro de 2003. Dispõe sobre o Estatuto do Idoso e dá outras providências [Internet]. 2003 [cited Aug 25, 2025]. Available from: https://www.planalto.gov.br/ccivil_03/leis/2003/l10.741.htm
3. Office of Disease Prevention and Health Promotion (ODPHP). Social determinants of health and older adults [Internet]. 2025 [cited Aug 25, 2025]. Available from: https://odphp.health.gov/our-work/national-health-initiatives/healthy-aging/socialdeterminants-health-and-older-adults
4. Zhang Z, Dong J, Lin F, Wang Q, Xu Z, He X, et al. Hot spots and difficulties of biliary surgery in older patients. Chin Med J (Engl). 2023;136(9):1037-46.doi:https://dx.doi.org/10.1097/CM9.0000000000002589
5. Seth I, Lim B, Cevik J, Gracias D, Chua M, Kenney OS, et al. Impact of nutrition on skin wound healing and aesthetic outcomes: a comprehensive narrative review. JPRAS Open. 2024;39:291-302. doi: https://doi.org/10.1016/j.jpra.2024.01.006
6. Norman K, Haß U, Pirlich M. Malnutrition in older adults-recent advances and remaining challenges. Nutrientes. 2021;13(8):2764. doi: http://doi.org/10.3390/nu13082764
7. Rêgo HMA, Rocha MESB, Albuquerque NJA, Azevedo DA, Oliveira Neto OM, Faria MR, et al. Cuidados perioperatórios: estratégias para melhorar os resultados em cirurgia geral. Braz J Implantol Health Sci. 2023;5(5):5115-39. doi: https://doi.org/10.36557/2674-8169.2023v5n5p5115-5139
8. Chrostek H, Rivero L. Nutritional care and ageing [Internet]. 2024 [cited Aug 25, 2025]. Available from:https://www.medicalnutritionindustry.org/nutritional-care-and-ageing
9. Miranda LSG, Amado JDN, Alves PJP. Importância da nutrição na cicatrização de feridas: uma scoping review. Rev Feridas [Internet]. 2023 [cited Aug 25, 2025];11(61):2248-52. Available from: https://www.revistaferidas.com.br/index.php/revistaferidas/article/view/3062
10. Kurmis R, Woodward M, Ryan H, Rice J. The importance of nutrition in wound management: new evidence from the past decade. Wound Pract Res. 2021;29(1):18-40. doi: http://doi.org/10.33235/wpr.29.1.18-40
11. Peters MDJ, Marnie C, Tricco AC, Pollock D, Munn Z, Alexander L, et al. Chapter 11: Scoping Reviews (2024version). In: Aromataris E, Munn Z, editors. JBI Manual for Evidence Synthesis. JBI; 2024. doi: https://doi.org/10.46658/JBIMES-24-01
12. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2020;169(7):467-73. doi: https://doi.org/10.1136/bmj.n71
13. Joanna Briggs Institute. JBI levels of evidence: supporting document—levels of evidence and grades of recommendation. Adelaide (AU): JBI [Internet]. 2020 [cited Aug 25, 2025]. Available from: https://jbi.global/sites/default/files/2020-07/Supporting_Doc_JBI_Levels_of_Evidence.pdf
14. Snyderman CH, Kachman K, Molseed L, Wagner R, D’Amico F, Bumpous J, et al. Reduced post operative infections with an immune-enhancing nutritional supplement. Laryngoscope. 1999;109(6):915-21. doi: https://dx.doi.org/10.1097/00005537-199906000-00014
15. Collins CE, Kershaw J, Brockington S. Effect of nutritional supplements on wound healing in home-nursedelderly: a randomizedtrial. Nutrition. 2005;21(2):147-55. doi: https://dx.doi.org/10.1016/j.nut.2004.10.006
16. Gao B, Luo J, Liu Y, Zhong F, Yang X, Gan Y, et al. Clinical efficacy of perioperative immunonutrition containing omega-3 fatty acids in patient sunder going hepatectomy: a systematic review and meta-analysis of randomized controlled trials. Ann Nutr Metab. 2020;76(6):375-86. doi: https://doi.org/10.1159/000509979
17. Antonescu I, Haines KL, Agarwal S. Role of nutrition in the elderly surgical patient – review of the literature and current recommendations. Curr Geriatr Rep. 2021;10(4):187-95. doi: https://doi.org/10.1007/s13670-021-00367-5
18. Arensberg MB, Phillips BE, Kerr KW. Nutrition for healing acute and chronic wounds: current practices, recente research out comes, and insights for improving care. Recent Prog Nutr. 2024;4(3):2-17. doi: https://doi.org/10.21926/rpn.2403014
19. Boccardi V, Marano L. Improving geriatric outcomes through nutritional and immunonutritional strategies: focus on the surgical setting via a comprehensive review of evidence. Aging Res Rev. 2024;96:102272. doi: https://doi.org/10.1016/j.arr.2024.102272
20. Triantafillidis JK, Malgarinos K. Immunonutrition in operated-on gastric cancer patients: an update. Biomedicines. 2024;12(12):2876. doi: https://doi.org/10.3390/biomedicines12122876
21. Weimann A, Bezmarevic M, Braga M, Correia MITD, Funk-Debleds P, Gianotti L, et al. ESPEN practical guideline: clinical nutrition in surgery – update 2025. Clin Nutr. 2025;53:222-61. doi: https://doi.org/10.1016/j.clnu.2025.08.029
22. García-Malpartida K, Aragón-Valera C, Botella-Romero F, Ocón-Bretón MJ, López-Gómez JJ. Effects of immunonutrition on cancer patients undergoing surgery: a scoping review. Nutrients. 2023;15(7):1776. doi: https://doi.org/10.3390/nu15071776
23. Aguilar-Nascimento JE, Bicudo-Salomão A, Ribeiro MRR, Dock-Nascimento DB, Caporossi C. Cost-effectiveness of the use of acerto protocol in major digestive surgery. ABCD Arq Bras Cir Dig. 2022;35:e1660. doi: https://dx.doi.org/10.1590/0102-672020210002e1660
24. Boccardi V, Cari L, Alhosseini MN, Bastiani P, Scamosci M, Caironi G, et al. Immunonutrition in acute geriatric care: clinical outcomes, inflammatory profiles, and immune responses. Nutrients. 2024;16(23):4211. doi: https://dx.doi.org/10.3390/nu16234211
25. Irani JL, Hedrick TL, Miller TE, Lee L, Steinhagen E, Shogan BD, et al. Clinical practice guidelines for enhanced recovery after colon and rectal surgery from the American Society of Colon and Rectal Surgeons and the Society of American Gastrointestinal and Endoscopic Surgeons. Surg Endosc. 2023;37(1):5-30. doi: https://doi.org/10.1007/s00464-022-09758-x
26. Brindle M, Nelson G, Lobo DN, Ljungqvist O, Gustafsson UO. Recommendations from the ERAS® Society for standards for the development of enhanced recovery after surgery guidelines. BJS Open. 2020;4(1):157-63. doi: https://dx.doi.org/10.1002/bjs5.50238
27. Sauro KM, Smith C, Ibadin S, Thomas A, Ganshorn H, Bakunda L, et al. Enhanced recovery after surgery guidelines and hospital length of stay, readmission, complications, and mortality: a meta-analysis of randomized clinical trials. JAMA Netw Open. 2024;7(6):e2417310. doi: https://doi.org/10.1001/jamanetworkopen.2024.17310
28. Grant MC, Engelman DT. Enhanced recovery after surgery: overarching themes of the ERAS® Society Guidelines & Consensus Statements for adult specialty surgery. Perioper Med (Lond). 2025;14(1):120. doi: https://dx.doi.org/10.1186/s13741-025-00590-0
29. Martínez-Ortega AJ, Piñar-Gutiérrez A, Serrano-Aguayo P, González-Navarro I, Remón-Ruíz PJ, Pereira Cunill JL, et al. Perioperative nutritional support: a review of current literature. Nutrients. 2022;14(8):1601. doi: https://doi.org/10.3390/nu14081601
30. Somnuke P, Pongraweewan O, Siriussawakul A. Optimizing perioperative care for elderly surgical patients: a review of strategies and evidence-based practices. Siriraj Med J. 2024;76(7):465-72. doi: https://doi.org/10.33192/smj.v76i7.268063
31. Volkert D, Beck AM, Cederholm T, Cruz-Jentoft A, Goisser S, Hooper L, et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clin Nutr. 2022;41(4):958-989. doi: https://doi.org/10.1016/j.clnu.2022.01.024
32. Yanni Z, Qiulin Z, Shanjun T, Hao L, Guohao W. Interpretation of ESPEN practical guideline: clinical nutrition and hydration in geriatrics. Chin J Dig Surg [Internet]. 2022 [cited Aug 25, 2025];21(6):708-25. Available from: http://zhxhwkzz.xml-journal.net/en/article/doi/10.3760/cma.j.cn115610-20220325-00164
33. Lambert K, Carey S. Dehydration in geriatrics: consequences and practical guidelines. Curr Opin Clin Nutr Metab Care. 2023;26(1):36-41. doi: https://doi.org/10.1097/MCO.0000000000000880
34. Gustafsson UO, Rockall TA, Wexner S, How KY, Emile S, Marchuk A, et al. Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations 2025. Surgery. 2025;184:109397. doi: https://doi.org/10.1016/j.surg.2025.109397
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Derechos de autor 2026 Pollyana Paula Almeida de Araújo, Geovanna Torres de Paiva, Raquel Bezerra Barbosa de Moura, Arthur Melo Cavalcanti, Eduardo Dalle Piagge Filho, Carmem Silvia Laureano Dalle Piagge, Cláudia Batista Mélo

Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.






