Background: Delayed or poor post-operative wound healing accounts for the majority of complications associated with major head and neck surgery. These complications lead to increased length of hospital stay, increased hospital costs, and delayed adjuvant treatment such as radiation and chemotherapy.

The head and neck cancer population is especially vulnerable to malnutrition; many of these patients experience dysphagia and odynophagia as cancer related symptoms due to the location of the primary tumor. Even in the absence of these symptoms, patients may have occult sarcopenia, which can be a predisposition to delayed wound healing after surgery.

IMPACT is an immune-based nutritional supplement containing arginine and omega 3 fatty acids. The IMPACT supplement has shown to decrease the incidence of infection, mortality, ventilator days, and length of ICU and hospital stay in critically ill patients.

Objectives: The purpose of this study is to determine whether nutritional optimization in head and neck cancer patients undergoing major surgery will decrease post-operative wound complications. It is likely that many head and neck cancer patients suffer from sarcopenia, and this contributes to many wound complications, including wound infection, dehiscence, fistula formation, and free flap tissue loss. We hypothesize that nutritional supplementation with Nestle Impact AR will decrease the rate of wound complications after surgery.