Delayed Wound Healing and Nutritional Deficiencies After Total Hip Arthroplasty

The Effect of Malnutrition on Patients Undergoing Elective Joint Arthroplasty

“…Malnourished patients also had significantly longer hospital stays which is consistent with historical data [6,8,13,18,30]. The overall rate of infection lower in this study compared to historical reports of malnourished patients [6][7][8]18].…”

“…There is direct support for the use of serum albumin and transferrin in screening for malnutrition and this combination was adopted for this study [4,13]. A threshold value of 3.5 mg/dl was used for serum albumin and 200 mg/dl for serum transferrin [5,13,23,34].…”

“…A threshold value of 3.5 mg/dl was used for serum albumin and 200 mg/dl for serum transferrin [5,13,23,34]. Although the threshold value for serum albumin has remained constant in most studies, the threshold values for transferrin differ ranging from 200 to 226 mg/dL [23,35].…”

“…In the orthopedic literature there are multiple studies demonstrating poor outcomes in malnourished patients undergoing elective joint arthroplasty, hip fractures and amputations [5][6][7][8][9][10]. The influence of malnutrition on the incidence of superficial or deep infection and wound related problems has also been the focus of many studies [11][12][13]. In one study evaluating total knee revisions with wound healing issues, over 88% of wound complications involved malnourished patients [14].…”

“…Serum albumin, total lymphocyte count and serum transferrin are commonly used to define nutritional status. The threshold defining malnutrition and the predictive value of using these markers have been questioned [13,19,20,22].…”