Supplementation with high-dose ascorbic acid improves intestinal anastomotic healing.
OBJECTIVE
Ascorbic acid modulates tissue healing but the value of ascorbic acid supplementation during anastomotic healing remains unclear. We examined the role of ascorbic acid treatment in experimental intestinal resection.


METHODS
Male Wistar albino rats (n = 30) were divided into three groups: sham treatment (group 1), and daily ascorbic acid treatment with 100 mg/kg (group 2) or 200 mg/kg (group 3) via the intramuscular route. Following sacrifice on the 7th postoperative day, bursting pressure of the anastomoses was measured. Hydroxyproline assessment and histological analysis were carried out.


RESULTS
The bursting pressure values of groups 2 (171.4 +/- 4.3 mm Hg) and 3 (196.4 +/- 2.2 mm Hg) were higher than that of group 1 (139.1 +/- 4.1 mm Hg; p < 0.05). In addition, the hydroxyproline level of group 3 (249.2 +/- 25.1 microg/mg) was higher than that of groups 1 (157.9 +/- 14.9 microg/mg) and 2 (187.9 +/- 14.8 microg/mg; p < 0.05). The histopathological scores indicated improved healing in groups 3 (6.0 +/- 0.2) and 2 (4.4 +/- 0.4), compared to group 1 (2.7 +/- 0.3; p < 0.05).


CONCLUSIONS
In the present study, supraphysiologic doses of ascorbic acid improved anastomotic healing. Therefore, vitamin C supplementation poses as a beneficial treatment in the context of collagen accumulation, inflammatory response, and anastomotic strength. However, the clinical value of high-dose ascorbic acid supplementation in the clinical setting is yet to be established.
Cevikel
M H
MH
Department of Surgery, Adnan Menderes University, Aydin, Turkey.
Tuncyurek
P
P
Ceylan
F
F
Meteoglu
I
I
Kozaci
D
D
Boylu
S
S
D000714:Anastomosis, Surgical; D000818:Animals; D001205:Ascorbic Acid / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D006909:Hydroxyproline / Q000378:metabolism; D007422:Intestines / Q000187:drug effects* / Q000473:pathology / Q000601:surgery*; D008297:Male; D023421:Models, Animal; D011312:Pressure; D051381:Rats; D017208:Rats, Wistar; D014815:Vitamins / Q000494:pharmacology*; D014945:Wound Healing / Q000187:drug effects*
D014815:Vitamins; D001205:Ascorbic Acid; D006909:Hydroxyproline