Surgical outcomes depend not only by what happens in the operation room, but also by the quality of preparation and recovery after surgery. This issue of Swiss/Knife highlights several key aspects of perioperative medicine, each contributing to safer operations and faster recovery.
Spahn and Spahn provide a comprehensive overview of Patient Blood Management, demonstrating how the systematic detection and treatment of anemia reduces transfusions, complications and costs.
Engel and colleagues discuss the value of prehabilitation. By improving fitness, nutrition, anemia and psychological resilience before surgery, patients are better equipped to withstand the stress of an operation.
Initially established for elective operations, the Enhanced Recovery After Surgery (ERAS) principles are now finding application in acute surgical care. In this issue, Taha and colleagues report that applying an ERAS protocol to emergency colorectal surgery is feasible and leads to better patient outcomes.
In their review, Pitteloud and Pfortmüller discuss the mechanisms of fluid accumulation and its consequences for patient outcomes, highlighting that timely fluid offloading after major surgery may facilitate organ recovery and expedite overall rehabilitation.
Pfister and colleagues critically evaluate the role of immunonutrition in major abdominal surgery. They show that, despite decades of enthusiasm, robust evidence for clinical benefit is lacking—particularly in modern, minimally invasive surgical practice.
Finally, Jent summarizes evidence-based strategies for preventing surgical site infections—reminding us that more than half of these complications remain preventable through consistent application of well-established measures.
Together, these contributions illustrate how perioperative medicine has become the backbone of modern surgical care. From optimizing blood and nutrition status to structured recovery pathways and infection prevention, each element plays a role in reducing complications and improving outcomes. Modern surgery extends beyond the scalpel- it begins with preparation and continues through recovery.
