We all know that healthy children usually need regular nourishment, including energy in the form of protein, carbohydrates, vitamins, fat and minerals, for their overall growth and maintenance. Surgical patients require a more enhanced nourishment compared to healthy children for optimum wound healing. The daily nutritional requirements of healthy children are met through balanced oral diet. However, unlikely in pediatric surgery patients who have restricted diets.Pediatric surgery is performed by surgeons who offer treatment for children.The aim of pediatric surgery differs with the procedure and the organ it being done on. In general, the aim is to surgically correct acongenital condition or disease, a traumatic injury, or alternative disorder within the pediatric patient.

Even thoughhealthy children have deposits of energy and protein that to lerate disease or injuries and help in survival and healing without external nutritional support, but these deposits are limited. Pediatric Surgeons should be aware of these nutritional limits and should regularly observe food habits of these patients and must ensure that enough nutritional support is provided as and when required.

Surgical Analysis For Pediatric Surgery Patients
Surgical analysis and treatments are associated with an increased requirement for nutritional support that include:
• Necrotizing enterocolitis
• Gastroschisis
• Perforating appendicitis
• Bowel resection

Compulsory Nutrition Required Daily
Children need daily vitamins like A, B6, B12, C, D, E, K,niacin, thiamin, folate, riboflavin, pantothenic acid, choline, biotin, minerals like fluoride, calcium, magnesium, iron, zinc phosphorus, essential fatty acids, and trace elements such as copper, chromium, selenium, molybdenum, iodine, manganese.

Earlier healthy children could survive without these nutrients for several days, but children who have been constantly underweight, have irregular GI losses, or need continued dietary support by now have or will develop serious deficits of Proteins, minerals, essential fatty acids, vitamins, and trace elements.

Conditions like Insulin infusions have shown results of decreased protein levels in critically deceased infants on extracorporeal membrane oxygenation (ECMO) when suitable nutritional protein is given.
Nutritional Assessment for Pediatric Surgery patients
The nutritional assessment of surgical patients is performed in several ways:
• Clinical examination based on previous or current medical treatments.
• Anthropometry
• Biochemical tests
• Body composition

Pre-Operative Nutritional Care
Malnutrition or under nourished children can be an interpreter of deprived surgical results. Pre-operative nutritional care can moderate the risk of post-operative complications in underweight patients but offers no help to healthy surgical patients. Substantial fall in sickness with the use of pre-operative nutritional care are seen in patients with severe under nutrition conditions. Pre-operative nutritional care, either enteral or parenteral, based on the position of the GI tract, and should be done for patients who are below the 5% - 10% in weight for their age.

Post-Operative Nutritional Care
The metabolic reaction to major surgery is not unlike that to major trauma. In the fasting post-operative patient, skeletal muscle protein is prepared to deliver protein for acute-phase reactants and wound healing process. Energy is provided mainly by activating fat stores. In this condition, total parenteral nutrition (TPN) provisions required energy to limit failure of body fat and protein, and this nutritional therapy stops reduction of skeletal muscle by providing adequate protein to maintain the circulating amino acid pool and helps in tissue repair.

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