Collagen synthesis is depressed systemically in the immediate postoperative period. Arginine, zinc and vitamin C impact collagen synthesis. The aim of this study is to investigate the effect of a pre and postoperative oral supplement consisting of arginine, zinc and vitamin C on collagen synthesis in patients undergoing inguinal hernia repair.
The trial investigates the effect of a pre and postoperative oral supplement consisting of arginine, zinc and vitamin C on collagen type I synthesis in patients undergoing inguinal hernia repair. The patients in the intervention group are given 55 mg zinc, 1251 mg vitamin C, and 15 g arginine once daily 14 days pre-operatively and post-operatively. Both groups receive high quality protein (1.5 g protein/kg body weight) daily during the same period. Hernia repair is done using the Lichtenstein technique. Drainage tubes are placed in the wound during the surgery. Epidermal wounds (10 mm) are made via the suction blister method on the ventral forearm of the patients on the day of surgery. Blood samples are drawn at day -14, day 0, day 1 and day 2. The surgical drain is emptied and fluid collected at day 1 and day 2.The healing of the suction blisters is assessed by clinical criteria until healing.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
20
The patients in the intervention group are given 55 mg zinc, 1251 mg vitamin C, and 15 g arginine once daily 14 days pre-operatively and post-operatively together with a high quality protein supplement.
High quality protein supplement 14 days pre-operatively and post-operatively.
Bispebjerg Hospital
Copenhagen, Copenhagen NV, Denmark
Changes in CICP levels in serum. CICP is the biomarker of type I collagen synthesis (carboxy-terminal propeptide of type I procollagen)
CICP is measured by enzyme-linked immunosorbent assay
Time frame: Day 2
Changes in CICP levels in wound fluid collected from surgical drain. CICP is the biomarker of type I collagen synthesis (carboxy-terminal propeptide of type I procollagen).
CICP is measured by enzyme-linked immunosorbent assay
Time frame: Day 1 and day 2
Changes in CICP levels in wound fluid collected from suction blisters. CICP is the biomarker of type I collagen synthesis (carboxy-terminal propeptide of type I procollagen).
CICP is measured by enzyme-linked immunosorbent assay
Time frame: Day 0
Changes in Zinc levels in serum
Zinc is measured by direct spectrophotometry
Time frame: Day -14, day 0, day 1 and day 2
Changes in Zinc levels in wound fluid collected from surgical drain
Zinc is measured by direct spectrophotometry
Time frame: Day 1 and day 2
Changes in Zinc levels in wound fluid collected from suction blisters
Zinc is measured by direct spectrophotometry
Time frame: Day 0
Changes in Arginine levels in serum
Arginine is measure by ultra-performance liquid chromatography and mass spectrometry
Time frame: Day -14, day 0, day 1 and day 2
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Healing of suction blisters
Clinical assessment
Time frame: Day 3 to Suction Blister healing
Compliance
Count of remaining supplement
Time frame: Day -14 to Suction Blister healing