Multinutrient Supplementation Increases Collagen Synthesis during Early Wound Repair in a Randomized Controlled Trial in Patients with Inguinal Hernia

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Marie Kjaer 1, Amalie Kruse Sigersted Frederiksen 1, Neel Ingemann Nissen 2, Nicholas Willumsen 2, Gerrit van Hall 3, Lars Nannestad Jorgensen 1, Jens Rikardt Andersen 4, Magnus S Ågren

Main idea: Oral supplementation with arginine, glutamine, vitamin C, and zinc augment collagen synthesis during the first 2 d after inguinal hernia repair.

Abstract

Background: Inguinal hernia disease is associated with an imbalanced collagen metabolism. Surgical stress has a negative impact on nutrients important for collagen synthesis.

Objective: We hypothesized that supplementation with a combination of nutrients would enhance collagen biosynthesis in inguinal hernia disease patients when undergoing hernia repair.

Methods: 21 men scheduled for Lichtenstein inguinal hernia repair were assigned to multinutrient supplementation or no supplementation. Collagen biosynthesis was measured by the biomarkers type I procollagen propeptide (CICP), type III procollagene propeptides (PRO-C3), and type V procollago propeptue ( PRO-C5) Collagen was found in the sera on days -14, 0, and 1, and in the wound fluids on postoperative days 1 and 2.

Results: Serum PRO-C5 concentrations decreased postoperatively in the control but not the multinutrient group. Neither CICP nor PRO-C3 serum concentrations differed significantly between the 2 groups. In wound fluid, the CICP concentrations increased from days 1 to 2 in the multinutrient group and were 49% higher than those in the control group on day 2. Wound fluid concentrations PRO-C3 and PRO-C5 showed no significant time or group differences. The 28-d compliance was similar in the 2 groups.

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