The effects of supplementation with a mixture of arginine, glutamine, and beta-hydroxy beta-methylbutyrate on the healing of colon anastomoses.
BACKGROUND
Several researchers have investigated how wound healing is effected by supplementation with each of the following amino acids : arginine (Arg), glutamine (Glu), and beta-hydroxy beta-methylbutyrate (HMB). This research investigates how a combination of these amino acids improves the wound healing associated with anastomoses.


METHODS
We tested the effects of a combination of Arg, Glu, and HMB on the healing of colon anastomoses in 50 male rats. We randomly divided the animals into two equal groups. In each animal, the cecum was transected from its midpoint to create an end-to end anastomosis. During the first postoperative week, Group 1 (G1) animals were fed standard chow, and Group 2 (G2) animals were fed standard chow plus a ready-to-use supplement that contained a mixture of Arg, Glu, and HMB. At the end of the week, all of the rats were sacrificed, and a cecum segment containing the anastomosis line was resected. Bursting pressure and tissue hydroxyproline were measured for all animals.


RESULTS
The mean values for hydroxyproline were 0.0013 ng/mg protein/ml (SD +/-0.00075) and 0.034 ng/mg protein/ ml (SD +/- 0.022) for G1 and G2, respectively (p <0.0001). The mean values for bursting pressure measurements were 122.8 mmHg (SD +/- 9.4) and 192.8 mmHg (SD+/- 31) for G1 and G2, respectively (p <0.0001). Statistically significant differences between the groups in terms of both bursting pressure levels and tissue hydroxyproline levels were observed.


CONCLUSIONS
In an animal model of colon surgery, supplementation with a combination of three amino acids seemingly benefits anastomosis healing.
Department of General Surgery, Diskapi Yildirim Beyazit Teaching and Research Hospital, Tandogan-Ankara, Turkey. dursek@yahoo.com
D
D
Seker
Department of Anesthesiology and Reanimation, Diskapi Yildirim Beyazit Teaching and Research Hospital, Tandogan-Ankara, Turkey.
J
J
Ergil
Department of Clinical Biochemistry, Diskapi Yildirim Beyazit Teaching and Research Hospital, Tandogan-Ankara, Turkey.
D
D
Ozkan
Department of General Surgery, Diskapi Yildirim Beyazit Teaching and Research Hospital, Tandogan-Ankara, Turkey.
M
M
Akinci
Department of Clinical Biochemistry, Diskapi Yildirim Beyazit Teaching and Research Hospital, Tandogan-Ankara, Turkey.
A
A
Yalcindag
Department of Clinical Biochemistry, Diskapi Yildirim Beyazit Teaching and Research Hospital, Tandogan-Ankara, Turkey.
Z
Z
Ginis
Department of General Surgery, Diskapi Yildirim Beyazit Teaching and Research Hospital, Tandogan-Ankara, Turkey.
G
G
Seker
Department of Anesthesiology and Reanimation, Diskapi Yildirim Beyazit Teaching and Research Hospital, Tandogan-Ankara, Turkey.
E
E
Arik
D000714:Anastomosis, Surgical; D057868:Anastomotic Leak / Q000517:prevention & control*; D000818:Animals; D001120:Arginine / Q000008:administration & dosage / Q000494:pharmacology*; D004338:Drug Combinations; D005973:Glutamine / Q000008:administration & dosage / Q000494:pharmacology*; D006909:Hydroxyproline / Q000032:analysis; D008297:Male; D051381:Rats; D017208:Rats, Wistar; D014631:Valerates / Q000008:administration & dosage / Q000494:pharmacology*; D014945:Wound Healing / Q000187:drug effects*
D004338:Drug Combinations; D014631:Valerates; D005973:Glutamine; C004961:beta-hydroxyisovaleric acid; D001120:Arginine; D006909:Hydroxyproline