Preoperative Assessment and Perioperative Management for High-Risk Surgery: Key Recommendations for Multidisciplinary Collaboration

The preoperative assessment of patients undergoing high-risk surgery is a critical process that requires thorough evaluation and careful management to minimize complications and improve postoperative outcomes. This preoperative assessment must be meticulous, considering factors such as comorbidities, nutritional status, and specific procedural risks. This article provides a review of evidence-based perioperative management recommendations to optimize patient preparation.

Diving into Perioperative Management

The perioperative management of patients undergoing high-risk surgery involves a series of multidisciplinary strategies. Multidisciplinary collaboration is essential to address the multiple aspects that can influence surgical outcomes. The implementation of prehabilitation programs, which include exercise, nutritional optimization, and psychological preparation, has been shown to reduce hospital stays and severe complications in frail and high-risk patients [1].

Preventing surgical site infections is another crucial component. The use of chlorhexidine and alcohol-based skin antiseptics, along with intranasal decolonization using anti-staphylococcal agents, has significantly reduced infection rates [2]. Additionally, perioperative glycemic control and maintenance of normothermia are effective interventions to improve surgical outcomes [3].

In the context of cardiac surgeries, identifying and managing preoperative risk factors such as obesity, hypoalbuminemia, and smoking are fundamental to reducing postoperative infections [4]. The administration of nasal mupirocin and chlorhexidine baths are recommended measures for the decolonization of S. aureus in these patients.

Conclusions

Proper preparation of patients for high-risk surgery is a complex process that requires a comprehensive, evidence-based approach. Multidisciplinary collaboration and the implementation of personalized perioperative management strategies are essential to optimize surgical outcomes. Adopting evidence-based practices, such as prehabilitation and infection prevention, can significantly improve quality of life and reduce complications in patients undergoing high-risk surgery.

Referencias

• [1] The impact of prehabilitation on outcomes in frail and high-risk patients undergoing major abdominal surgery: A systematic review and meta-analysis.
• [2] Surgical Site Infection Prevention: A Review.
• [3] Perioperative Pulmonary Atelectasis: Part II. Clinical Implications.
• [4] Surgical Site Infection in Cardiac Surgery.

Created 13/1/2025