Kayal Orthopaedic Center
Kayal ERAS
Enhanced Recovery After Surgery
A perioperative nutritional optimization protocol designed to identify deficiencies, intervene early, and accelerate recovery for orthopaedic surgery patients.
Protocol Overview
Preoperative Bloodwork
Screen serum Zinc, Vitamin A, Vitamin D, Vitamin C, Prealbumin, Transferrin, and Calcium levels to identify nutritional deficiencies.
Calculate GNRI
Use the Geriatric Nutritional Risk Index to stratify patients into no risk, moderate risk, or severe risk categories.
Nutritional Supplementation
Moderate-to-severe risk patients begin Essential Amino Acids, Whey Protein, Creatine, and HMB supplementation 2 weeks preoperatively, continuing 6 weeks postoperatively.
Preoperative Carbohydrate Loading
ALL patients consume 100g of complex carbohydrates (e.g., Gatorade equivalent) the night before surgery.
Postoperative Monitoring
At 6 weeks post-op, repeat GNRI and any bloodwork that was significantly abnormal preoperatively to assess intervention efficacy.
Preoperative Bloodwork Panel
Screen for nutritional deficiencies prior to surgical intervention
Serum Zinc
Vitamin A
Vitamin D (25-OH)
Vitamin C
Prealbumin
Transferrin
Calcium