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


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.


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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