Skip to main content Skip to main navigation menu Skip to site footer

Postoperative supplementation effect of zinc and vitamin C in primary colonic anastomosis on peritonitis condition: A study on New Zealand rabbit



Abstract

Background: Colon has the highest risk of anastomotic leakage and increases 2.5-fold in peritonitis. To prevent leakage of colonic anastomosis, there are some modalities to upgrade the quality of wound healing. The mineral zinc is good for healing intestinal anastomotic wounds and vitamin C, whose function is related to wound healing and maintaining vascular integrity. This study investigated the effect of daily zinc and vitamin C supplementing on rabbits with peritonitis who underwent colonic anastomosis.

Material and methods: Thirty-six New Zealand rabbits underwent peritonitis 5 hours after they continued with a laparotomy to wash the abdominal cavity and colonic anastomosis. The rabbits were then divided into 2 groups. First group was given zinc and vitamin C syrup, while the second group was given normal saline without zinc and vitamin C. On the 6-day postoperative, the rabbits were terminated, and tissue was collected at the colonic anastomosis to examine the histological score of anastomotic wound healing.

Results: Significant differences in anastomotic healing in terms of histological scores (collagen density α=0.00, p<0.05; Neovascularisation α=0.00, p<0.05; Fibroblasts, α=0.00, p<0.05). This study generally explains the relationship between zinc and vitamin C administration and colonic anastomosis wound healing in peritonitis.

Conclusion: There were significant differences in histological wound healing scores (collagen density, neovascularization, fibroblasts) in the treatment group compared to the control group.

Keywords: Colon Anastomotic Peritonitis Zinc Vitamin C

References

  1. Jannasch O, Klinge T, Otto R, Chiapponi C, Udelnow A, Lippert H, et al. Risk factors, short and long term outcome of anastomotic leaks in rectal cancer. Oncotarget. 2015;6(34):36884–93. Available from: https://pubmed.ncbi.nlm.nih.gov/26392333
  2. Ross JT, Matthay MA, Harris HW. Secondary peritonitis: principles of diagnosis and intervention. BMJ. 2018;361:k1407–k1407. Available from: https://pubmed.ncbi.nlm.nih.gov/29914871
  3. Hyman N, Manchester TL, Osler T, Burns B, Cataldo PA. Anastomotic leaks after intestinal anastomosis: it’s later than you think. Ann Surg. 2007;245(2):254–8. Available from: https://pubmed.ncbi.nlm.nih.gov/17245179
  4. Kothiya PK, Sharma DB, Solanki FS, Tiwari AK, S. K. C. Effect of Vitamin C Supplementation on Colonic Anastomotic Healing in the Presence of Peritonitis- An Experimental Study in Rats. J Evol Med Dent Sci. 2020;9(23):1730–3. Available from: http://dx.doi.org/10.14260/jemds/2020/380
  5. Phillips B. Reducing gastrointestinal anastomotic leak rates: review of challenges and solutions. Open Access Surg. 2016;5. Available from: http://dx.doi.org/10.2147/oas.s54936
  6. Lin P-H, Sermersheim M, Li H, Lee PHU, Steinberg SM, Ma J. Zinc in Wound Healing Modulation. Nutrients. 2017;10(1):16. Available from: https://pubmed.ncbi.nlm.nih.gov/29295546
  7. Livingstone C. Zinc. Nutr Clin Pract. 2015;30(3):371–82. Available from: http://dx.doi.org/10.1177/0884533615570376
  8. Utomo MT, Sudarmo SM, Sudiana K. Zinc supplementation in cytokine regulation during LPS-induced sepsis in rodent. J Int Dent Med Res. 2020;13(1):46–50.
  9. Moores J. Vitamin C: a wound healing perspective. Br J Community Nurs. 2013;18(Sup12):S6–11. Available from: http://dx.doi.org/10.12968/bjcn.2013.18.sup12.s6
  10. M. Yussif N. Vitamin C [Internet]. Vitamin C - an Update on Current Uses and Functions. IntechOpen; 2019. Available from: http://dx.doi.org/10.5772/intechopen.81783
  11. Tochie JN, Agbor NV, Frank Leonel TT, Mbonda A, Aji Abang D, Danwang C. Global epidemiology of acute generalised peritonitis: a protocol for a systematic review and meta-analysis. BMJ Open. 2020;10(1):e034326–e034326. Available from: https://pubmed.ncbi.nlm.nih.gov/31919127
  12. Offobo SN, Nyamatsiengui H, Obame LC, Albert Aseke KJ, N’Dong FO. The Epidemiological Profile of Acute Peritonitis and Sensitivity to Antibiotics, about 167 Cases, in the General Surgery Department of the Amissa Bongo Regional Hospital Center in Franceville, Gabon. Surg Sci. 2022;13(06):307–16. Available from: http://dx.doi.org/10.4236/ss.2022.136039
  13. Lansdown ABG, Mirastschijski U, Stubbs N, Scanlon E, Ågren MS. Zinc in wound healing: Theoretical, experimental, and clinical aspects. Wound Repair Regen. 2007;15(1):2–16. Available from: http://dx.doi.org/10.1111/j.1524-475x.2006.00179.x
  14. Binnebösel M, Grommes J, Koenen B, Junge K, Klink CD, Stumpf M, et al. Zinc deficiency impairs wound healing of colon anastomosis in rats. Int J Colorectal Dis. 2009;25(2):251–7. Available from: http://dx.doi.org/10.1007/s00384-009-0831-y
  15. Alker W, Haase H. Zinc and Sepsis. Nutrients. 2018;10(8):976. Available from: https://pubmed.ncbi.nlm.nih.gov/30060473
  16. Ågren MS, Andersen L, Heegaard AM, Jorgensen LN. Effect of parenteral zinc sulfate on colon anastomosis repair in the rat. Int J Colorectal Dis. 2008;23(9):857–61. Available from: http://dx.doi.org/10.1007/s00384-008-0501-5
  17. Sutarja N, Ariandi S, Hariastawa I. Effects of Postoperative Zinc Supplementation on Improving the Quality of Wound Healing in Primary Colonic Anastomosis with Peritonitis Model (New Zealand Rabbit Study). Int J Creat Res Thoughts. 2021;9(12):e530–5.
  18. Gurtner GC, Wong VW. Wound healing: normal and abnormal. Grabb Smith’s Plast Surg. 2007;6:15–22.
  19. Docherty JG, McGregor JR, Akyol AM, Murray GD, Galloway DJ. Comparison of manually constructed and stapled anastomoses in colorectal surgery. West of Scotland and Highland Anastomosis Study Group. Ann Surg. 1995;221(2):176–84. Available from: https://pubmed.ncbi.nlm.nih.gov/7857145
  20. Warsinggih W, binti Abadi NA, Prihantono P. The Relationship of Early Feeding and the Length of Stay in Post-gastrointestinal Surgery Patients.
  21. Danielski LG, Walczewski E, de Jesus CR, Florentino D, Giustina A Della, Goldim MP, et al. Preoperative vitamin C supplementation improves colorectal anastomotic healing and biochemical parameters in malnourished rats. Int J Colorectal Dis. 2016;31(11):1759–66. Available from: http://dx.doi.org/10.1007/s00384-016-2647-x

How to Cite

Luh Putu Neolita Pradnya Wineni, Adria Hariastawa, & Ariandi Setiawan. (2023). Postoperative supplementation effect of zinc and vitamin C in primary colonic anastomosis on peritonitis condition: A study on New Zealand rabbit. Bali Medical Journal, 12(1), 641–646. https://doi.org/10.15562/bmj.v12i1.4077
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver
Download Citation
Endnote/Zotero/Mendeley (RIS) BibTeX

HTML
4

Total
1

Share

Search Panel

Luh Putu Neolita Pradnya Wineni
Google Scholar
Pubmed
BMJ Journal

Adria Hariastawa
Google Scholar
Pubmed
BMJ Journal

Ariandi Setiawan
Google Scholar
Pubmed
BMJ Journal