Preoperative vitamin C supplementation improves colorectal anastomotic healing and biochemical parameters in malnourished rats

Danielski, Lucinéia Gainski; Walczewski, Eduardo André Bracci; Jesus, Clovisa Reck de; Florentino, Drielly; Giustina, Amanda Della; Κanis, Luiz Alberto; Pereira, Gregório Wrublevski; Pereira, Volnei D.; Felisberto, Francine; Petronilho, Fabrícia

doi:10.1007/s00384-016-2647-x

Cited by 9 publications

(12 citation statements)

References 48 publications

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“… 34 , 35 It has also been reported in several animal studies that administration of a very high dose of vitamin C results in an increase in collagen density in the mesenchymal tissue. 36 , 37 , 38 But these studies differ from ours in the amount of vitamin C administered, which can be as much as 75–100 mg/kg per day. As a result, we can assume that any supplement targeting an increase in collagen synthesis through the known effects of vitamin C should have meticulous dose-effect studies and possibly intoxication studies as well.…”

Section: Discussioncontrasting

confidence: 57%

“…To overcome this problem, further studies are needed with deficient animal models, but to our knowledge there are no proven deficient animal models or reported deficiency for any of our trial supplement's ingredients, except vitamin C. It is known that in-vitro fibroblast cultures treated with vitamin C exhibit increased synthesis of COL1 34, 35. It has also been reported in several animal studies that administration of a very high dose of vitamin C results in an increase in collagen density in the mesenchymal tissue 36, 37, 38. But these studies differ from ours in the amount of vitamin C administered, which can be as much as 75–100 mg/kg per day.…”

Section: Discussionmentioning

confidence: 90%

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Role of a combination dietary supplement containing mucopolysaccharides, vitamin C, and collagen on tendon healing in rats

Gemalmaz¹,

Sariyilmaz²,

Özkunt³

et al. 2018

Acta Orthopaedica et Traumatologica Turcica

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ObjectiveThe aim of this study was to investigate the effect of mucopolysaccharide, vitamin C, and collagen supplementation on the healing of Achilles tendon in rats.MethodsSixteen rats were separated into 2 groups. Both Achilles tendons of all rats were transected 5 mm above the insertion and repaired using a Kessler suture. After the surgical repair, the study group received the daily recommended amount of the supplement by gastric gavage, while the control group received a placebo. At the end of the third week, the animals were sacrificed. The biomechanical properties of the groups were compared with ultimate tensile strength and stiffness tests. The biological properties of the 2 groups were assessed with a histomorphometric comparison to determine the amount of collagen type I (COL1), proliferating cell nuclear antigen (PCNA), and transforming growth factor β1 (TGF-β1) expression in 3 different tissue subgroups (collagen matrix, tenocytes, and endotenon fibroblasts).ResultsAnalysis of histomorphometric results revealed that the rats receiving dietary supplements demonstrated a significant increase in PCNA (mean value of 86 in the control group and 168.85 in the trial group; p < 0.05) and TGF-β1 (mean value of 87.57 in the control group and 161.85 in the trial group; p < 0.05) in the endotenon fibroblasts of the repair site. However, there was no difference between the groups in PCNA or TGF-β1 when the collagen matrix and the tenocytes of the repair site were examined. Furthermore, no significant difference could be found between groups in COL1 in any of the 3 tissue subgroups (collagen matrix, tenocytes, and endotenon fibroblasts). The statistical analysis also indicated that the rats receiving supplements did not demonstrate a significant increase in the ultimate tendon tensile strength or stiffness.ConclusionThe results of this study revealed no advantage to the oral administration of the trial supplement in collagen synthesis or biomechanical properties in rats after 3 weeks using the presented study design. However, the increased expression of PCNA and TGFβ1 seen in the endotenon fibroblasts of the repair site might play a role in the continuum of tendon healing.

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Section: Discussioncontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 90%

Role of a combination dietary supplement containing mucopolysaccharides, vitamin C, and collagen on tendon healing in rats

Gemalmaz¹,

Sariyilmaz²,

Özkunt³

et al. 2018

Acta Orthopaedica et Traumatologica Turcica

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“…Although preoperative AA levels did not have significant effects on postoperative rehabilitation and complications in this study, the postoperative clinical findings regarding Delta and especially the AA status at T4 indicates clinical advantages of an AA supplementation. There are some publications outlining the protective and beneficial antioxidative effects of pre-and perioperative AA supplementation on postoperative clinical outcome in cardiac surgery [62], general surgery [63] and sepsis treatment [64,65]. The AA supplementation does not only have beneficial antioxidative effects, but also massive impact on bone metabolism [16,19,66,67].…”

Section: Discussionmentioning

confidence: 99%

Preoperative Ascorbic Acid Levels in Proximal Femur Fracture Patients Have No Postoperative Clinical Impact, While Ascorbic Acid Levels upon Discharge Have a Major Effect on Postoperative Outcome

Hill-Mündel

Schlegl²,

Biesalski

et al. 2019

JCM

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Proximal femur fractures show a high prevalence in elderly patients and are associated with an elevated risk of multimorbidity and early mortality. Recovery is impaired by malnutrition and oxidative stress, which is affected by antioxidants such as ascorbic acid (AA). This study monitored AA levels during hospitalization of patients with a proximal femur to investigate the influence of AA status to the clinical outcome. AA levels of 25 elderly patients with a proximal femur fracture were measured during hospitalization using high performance liquid chromatography. Plasma samples were collected preoperatively, on the first day after surgery, on the third day after surgery and on the day of discharge. Nutritional Risk Screening 2002 (NRS) and Mini Nutritional Assessment (MNA) were assessed to evaluate the nutritional status. In patients with proximal femoral fractures, preoperative AA concentrations were significantly lower compared to elderly patients without an acute fracture. A significant decrease of 33.8% in AA plasma level was measured on the day after surgery with a significant recovery up to the time of discharge. The preoperative AA status did not have any significant effect on clinical outcome. However, inadequate AA levels (<50 µmol/L) upon discharge significantly increased the incidence and the severity of postoperative complications. These results indicate that the AA status upon discharge has a greater impact on clinical outcome than assumed, and therefore, AA supplementation during hospitalization should be considered.

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“…Vitamin C is directly involved and required for collagen synthesis and wound healing 1–4. Some studies have indicated that supplementation with vitamin C in malnourished patients improves outcomes in surgical patients and is crucial to ensuring adequate healing and wound resolution postsurgery 4 15 16…”

Section: Discussionmentioning

confidence: 99%

Severe scurvy in a patient with eosinophilicoesophagitis

Weitzel

Moon²

2019

BMJ Case Rep

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While scurvy is considered to be a rare disease in the modern era, the disease still presents in certain populations with nutritional deficiencies such as those with poor nutritional absorption secondary to gastrointestinal disorders and in patients with poor nutritional intake. We present a case of scurvy in a patient who had eosinophilic oesophagitis which limited his oral intake. He presented with the classic symptoms of scurvy including a perifollicular rash, arthralgia, gingivitis and anaemia. He was treated with intravenous vitamin C initially followed by an oral course after which he showed improvement. This case demonstrates that it is important to consider vitamin C deficiency in patients with who present with anaemia and bleeding stigmata specifically in those who have poor nutritional intake. Furthermore, additional consideration should be given to patients with malnutrition as part of the preoperative evaluation.

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Preoperative vitamin C supplementation improves colorectal anastomotic healing and biochemical parameters in malnourished rats

Abstract: Preoperative vitamin C supplementation can improve the intestinal anastomosis healing, biochemical alterations, and prolong survival in rats subjected to food restriction.

Cited by 9 publications

References 48 publications

Role of a combination dietary supplement containing mucopolysaccharides, vitamin C, and collagen on tendon healing in rats

Role of a combination dietary supplement containing mucopolysaccharides, vitamin C, and collagen on tendon healing in rats

Preoperative Ascorbic Acid Levels in Proximal Femur Fracture Patients Have No Postoperative Clinical Impact, While Ascorbic Acid Levels upon Discharge Have a Major Effect on Postoperative Outcome

Severe scurvy in a patient with eosinophilicoesophagitis

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