Table 1.

Surgeons’ general knowledge of nutrition.

Items of the Questionnaire	Number of Responses (%)
What do you consider that is the most appropriate definition of malnutrition?
−Is the nutritional state due to a decrease in the intake or incorporation of nutrients that leads to an alteration n body composition resulting in a reduction of functional and mental capacity, as well as worsening of clinical outcome	95 (81.9)
−Is the one that affects in a very special way to a particular group, such as hospitalized subjects in which disability and disease are common, taking an own entity	1 (0.9)
−Is that in which there is a decrease of albumin and total proteins due to any intercurrent process	10 (8.6)
−None of them	9 (7.8)
Don’t know/no answer	1 (0.9)
In your opinion, with what parameters is malnutrition most accurately diagnosed?
−With the decrease of albumin and prealbumin	86 (74.1)
−With unintentional weight loss together with a fasting or semi-fasting period of more than one week	14 (12.1)
−With a body mass index < 20 kg/m2	10 (8.6)
−With a decrease of plasma levels of cholesterol and lymphocytes	4 (3.4)
Don’t know/no answer	2 (1.7)
In your opinion, how malnutrition that occurs in the surgical patient should be classified?
−Malnutrition related to the chronic disease with inflammation	21 (18.1)
−Malnutrition related to fasting	10 (8.6)
−Malnutrition related to the acute disease	36 (31.0)
−Protein malnutrition	40 (34.5)
Don’t know/no answer	9 (7.8)
Which of the following questionnaires would you NOT use for nutritional screening?
−MST (Malnutrition Screening Tool)	4 (3.4)
−MUST (Malnutrition Universal Screening Tool)	6 (5.2)
−Charlson	63 (54.3)
−MNA-SF (Mini-Nutritional Assessment Short-Form)	12 (10.3)
Don’t know/no answer	31 (26.7)
What definition of enteral nutrition do you consider most appropriate?
−Form of feeding in which the physiological route of the access of food to the digestive system is modified by artificial means	9 (7.8)
−Form of feeding in which the physiological route of the access of food to the digestive system is modified by artificial means, or the physicochemical composition of the nutritional mixture	70 (60.3)
−Form of feeding in which the physicochemical composition of the nutritional mixture is modified	22 (19.0)
−None of them	15 (12.9)
In your opinion, where should the tip of a central venous catheter be placed in order to start total parenteral nutrition?
−In the subclavian vein	25 (21.6)
−In the cephalic vein	1 (0.9)
−In the superior cavoatrial junction	80 (69.0)
−In the brachiocephalic trunk	9 (7.8)
Don’t know/no answer	1 (0.9)
In relation to preoperative nutritional support in patients undergoing a major abdominal surgical procedure, which of the following statements do you consider to be true?
−It is indicated in all patients with severe malnutrition for a period of 7–14 days, even if oncological surgery has to be delayed	64 (55.2)
−Surgery should never be delayed to improve the nutritional status if the patient has an oncological disease	1 (0.9)
−It is only indicated in patients who cannot be nourished by the oral route	1 (0.9)
−7 days of preoperative nutritional support improves the nutritional status (body composition and albumin levels)	44 (37.9)
Don’t know/no answer	6 (5.2)
How long do you consider it is necessary to maintain total parenteral nutrition (TPN) to achieve any postoperative clinical benefit?
−At least 3 days	14 (12.1)
−At least 5–7 days	72 (62.1)
−More than 7 days	22 (19.0)
−At least 48 h	5 (4.3)
Don’t know/no answer	3 (2.6)
What do you consider that are the advantages of enteral infusion of nutrients in the early postoperative period? Mark all options that apply
−To preserve the integrity of the intestinal mucosa (structure and function) and, therefore, the gastrointestinal barrier	109 (93.7)
−To improve blood flow and mesenteric oxygenation	68 (58.6)
−To reduce bacterial translocation and maintain immunocompetence	93 (80.2)
In your opinion, which of the following statements regarding postoperative nutritional support is correct?
−TPN should be routinely administered postoperatively in patients with major gastrointestinal surgery	0
−Nutritional support after surgery should be administered in those patients in whom fasting times of at least 3–5 days are anticipated	37 (31.9)
−TPN is indicated postoperative when complications occur in association with intestinal failure, which make it foreseeable that the patient will be unable to meet their nutritional requirements through oral (enteral) intake for a period of 7–10 days in case of being malnourished	26 (22.4)
−TPN is indicated postoperative when complications occur in association with intestinal failure, which make it foreseeable that the patient will be unable to meet their nutritional requirements through oral (enteral) intake for a period of 7–10 days if he/she is normally nourished	47 (40.5)
Don’t know/no answer	6 (5.2)
In most patients, when do you consider that oral diet should be started after major abdominal surgery?
−In the first 24 h	111 (95.7)
−When there is passage of feces	0
−When there is no leak in the intestinal transit	2 (1.7)
−After 5 days because it is considered to be the most appropriate period for the protection of sutures	1 (0.9)
Don’t know/no answer	2 (1.7)
Regarding immunonutrition, add those statements that in your opinion are correct. Mark all options that apply
−Currently there is no clear evidence to recommend its use only in the preoperative period	29 (25.0)
−Its administration is recommended in the peri and postoperative period of malnourished patients with cancer	78 (67.2)
−Its use is associated with a significant reduction of postoperative complications and length of hospital stay	81 (69.8)
−It is not cost-effective	2 (1.7)
Don’t know/no answer	6 (5.2)
In relation to peripheral parenteral nutrition, select those statements that in your opinion are correct. Mark all options that apply
−Nutrients are infused into the bloodstream through a peripheral vein	100 (86.2)
−With this type of nutritional support, 100% of the patient’s nutritional requirements are not usually covered	87 (75.0)
−It is indicated for periods of less than 7 days	95 (81.9)
−It is indicated in those patients who require fluid restriction, e.g., heart or liver failure	10 (8.6)