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Background: Pharmaconutrition has previously been reported in elective surgery to reduce postoperative infective complications and duration of hospital length of stay. Objective: To update previously published meta‐analyses and elucidate potential benefits of providing arginine‐dominant pharmaconutrition in surgical patients specifically with regard to the timing of administration of pharmaconutrition. Design: Randomized controlled trials comparing the use of pharmaconutrition with standard nutrition in elective adult surgical patients between 1980 and 2011 were identified. The meta‐analysis was prepared in accordance with Preferred Reporting of Systematic Reviews and Meta‐Analyses (PRISMA) recommendations. Results: Twenty studies yielding 21 sets of data met inclusion criteria. A total of 2005 patients were represented (pharmaconutrition, n = 1010; control, n = 995), in whom pharmaconutrition was …