Objective: The purpose of this study is to examine the effects of L-carnitine on healing of experimental colon anastomosis injury in
early and late period.
Materials and Methods: Forty female Wistar-Albino rats were used in this study. The rats were divided into 4 groups (CONT-3, CONT-
7, CARN-3, and CARN-7). Injury healing was evaluated for CONT-3 group on the 3rd day and for CONT-7 group on the 7th day
following the anastomosis. Following the operation, CARN-3 and CARN-7 groups were intraperitoneally administered with 100 mg/
kg/day L-carnitine and injury healing was evaluated on the 3rd and 7th days. Injury strength, histological evaluation and antioxidant
enzyme activities and oxidant damage were determined in tissue samples of anastomosis area.
Results: Bursting pressure levels and histological scoring values of CARN-3 group were found to be higher than the CONT-3 group
(p<0.05). Antioxidant enzyme activities were found to be high in groups which were administered with L-carnitine, and oxidant
damage was found to be significantly low in CARN-7 group (p<0.05).
Conclusion: It was seen that L-carnitine speeds up the injury healing process and increases the injury strength and antioxidant capacity
in early period. Increase in antioxidant enzyme activities was observed to be continued in late period as well.
Kirchhoff P, Clavien PA, Hahnloser D. Complications in
colorectal surgery: risk factors and preventive strategies.
Patient Saf Surg 2010; 4:5. doi: 10.1186/1754-9493-4-5
Ruiz-Tovar J, Morales-Castiñeiras V, Lobo-Martínez E.
Postoperative complicactions of colon surgery. Cir Cir 2010;
78:283-91.
Gülçin I. Antioxidant and antiradical activities of L-carnitine.
Life Sci 2006; 78:803-11. doi: 10.1016/j.lfs.2005.05.103
Kutluay Köklü AH, Küpeli Akkol E, Uğar Çankal DA.
Biochemical and biomechanical assessment of effects of
L-carnitine on oral mucosal wounds. Clin Oral Investig 2015;
19:1101-6. doi: 10.1007/s00784.014.1329-8
Bell FP, Vidmar TJ, Raymond TL. L-carnitine administration
and withdrawal affect plasma and hepatic carnitine
concentrations, plasma lipid and lipoprotein composition,
and in vitro hepatic lipogenesis from labeled mevalonate
in normal rabbits. J Nutr 1992; 122:959-66. doi: 10.1093/
jn/122.4.959
Arduini A. Carnitine and its acyl esters as secondary
antioksidants? Am Heart J 1992; 123:1726-7. doi:
10.1016/0002-8703(92)90850-u
Sabry MM, Ahmed MM, Maksoud OMA, et al. Carnitine,
apelin and resveratrol regulate mitochondrial quality control
(QC) related proteins and ameliorate acute kidney injury: role
of hydrogen peroxide. Arch Physiol Biochem 2020; 13:1-10.
doi: 10.1080/13813.455.2020.1773504
Zhao T, Chen S, Wang B, Cai D. L-Carnitine Reduces
Myocardial Oxidative Stress and Alleviates Myocardial
Ischemia-Reperfusion Injury by Activating Nuclear
Transcription-Related Factor 2 (Nrf2)/Heme Oxygenase-1
(HO-1) Signaling Pathway. Med Sci Monit 2020; 26:e923251.
doi: 10.12659/MSM.923251
Akkus A, Aydinuraz K, Daphan C, et al. Effect of carnitine on
cutaneous wound healing in immunosuppressed rats. J Surg
Res 2009; 155:301-5. doi: 10.1016/j.jss.2008.06.010
Choi BS, Song HS, Kim HR, et al. Effect of coenzyme Q10 on
cutaneous healing in skin-incised mice. Arch Pharm Res 2009;
32:907-13. doi: 10.1007/s12272.009.1613-3
Cakmak GK, Irkorucu O, Ucan BH, et al. The effects of
resveratrol on the healing of left colonic anastomosis. J Invest
Surg 2009(a); 22:353-61. doi: 10.1080/089.419.30903214701
Kabali B, Girgin S, Gedik E, Ozturk H, Kale E, Buyukbayram
H. N-Acetylcysteine prevents deleterious effects of ıschemia/
reperfusion ınjury on healing of colonic anastomosis in rats.
Eur Surg Res 2009; 43:8–12. doi: 10.1159/000210673
Cakmak GK, Irkorucu O, Ucan BH, et al. Simvastatin
improves wound strength after intestinal anastomosis in the
rat. J Gastrointest Surg 2009(b); 13:1707-16. doi: 10.1007/
s11605.009.0951-2
Kurahashi T, Fujii J. Roles of Antioxidative Enzymes in Wound
Healing. J Dev Biol 2015; 3:57-70. https://doi.org/10.3390/
jdb3020057
Xu Z, Han S, Gu Z, Wu J. Advances and Impact of Antioxidant
Hydrogel in Chronic Wound Healing. Adv Healthc Mater
2020; 9:e1901502. doi: 10.1002/adhm.201901502
Charan J, Kantharia ND. How to calculate sample size in
animal studies? J Pharmacol Pharmacother 2013; 4:303-6.
doi:10.4103/0976-500X.119726
Arifin WN, Zahiruddin WM. Sample Size Calculation in
Animal Studies Using Resource Equation Approach. Malays J
Med Sci 2017; 24:101-5. doi: 10.21315/mjms2017.24.5.11
Demir U, Edremitlioğlu M, Kandaş E, Şehitoğlu MH,
Kılınç N. Quercetin associated with dimethylsulfoxide
has a curative effect on experimental colon anastomosis
injury. Acta Cir Bras 2020; 35:e202000602. doi: 10.1590/
s0102.865.0202000.600.00002
Goel SA, Nagpal P, Nagarajan P, Panda A K, Chhabra HS.
Lateral approach to the lumbar spine of sprague dawley rat:
development of a novel animal model for spine surgery. Indian
Spine J 2019; 2:134-37.
Irvin TT, Hunt TK. Pathogenesis and prevention of disruption
of colonic anastomoses in traumatized rats. Br J Surg 1974;
61:437-39. doi: 10.1002/bjs.180.061.0605.
Yagi K. Assay of lipid peroxidation in blood plasma or serum.
Methods Enzymol 1984; 105: 328-31. doi: 10.1016/s0076-
6879(84)05042-4
Chiu CJ, McArdle AH, Brown R, Scott HJ, Gurd FN. Intestinal
mucosal lesion in low-flow states. I. A morphological,
hemodynamic, and metabolic reappraisal. Arch Surg 1970;
101:478-83. doi: 10.1001/archsurg.1970.013.40280030009
Poon P, Law WL, Chu KW, Wong J. Emergency resection and
primary anastomosis for left-sided obstructing colorectal
carcinoma in the elderly. Br J Surg 1998; 85:1539-42. doi:
10.1046/j.1365-2168.1998.00903.x
Thornton FJ, Barbul A. Healing in the gastrointestinal tract.
Surg Clin North Am 1997; 77: 549-73. doi: 10.1016/s0039-
6109(05)70568-5
Oines MN, Krarup PM, Jorgensen LN, Agren MS.
Pharmacological interventions for improved colonic
anastomotic healing: a meta-analysis. World J Gastroenterol
2014;20:12637-48. doi: 10.3748/wjg.v20.i35.12637.
Hensley K, Kotake Y, Sang H, et al. Dietary choline restriction
causes complex I dysfunction and increased H(2)O(2)
generation in liver mitochondria. Carcinogenesis 2000;
21:983-9. doi: 10.1093/carcin/21.5.983
Blokhina O, Virolainen E, Fagerstedt KV. Antioxidants,
oxidative damage and oxygen deprivation stress: a review.
Ann Bot 2003; 91:179-94. doi: 10.1093/aob/mcf118
Bayir H. Reactive oxygen species. Crit Care Med 2005; 33(12
Suppl):S498-501. doi: 10.1097/01.ccm.000.018.6787.64500.12
Yager DR, Kulina RA, Gilman LA. Wound fluids: a window
into the wound environment? Int J Low Extrem Wounds 2007;
6:262-72. doi: 10.1177/153.473.4607307035
Moradi M, Moradi A, Alemi M, et al. Safety and efficacy
of clomiphene citrate and L-carnitine in idiopathic male
infertility: a comparative study. Urology J 2010; 7:188-93.
doi:10.22037/UJ.V7I3.750
Kunnavatana SS, Quan SY, Koch RJ. Combined effect of
hyberbaric oxygen and N-acetylcysteine on fibroblast
proliferation. Arch Otolaryngol Head Neck Surg 2005;131:809-
14. doi: 10.1001/archotol.131.9.809
Broughton G II, Janis JE, Attinger CE. The basic science of
wound healing, Plast Reconstr Surg 2006;117: 12-34. doi:
10.1097/01.prs.000.022.5430.42531.c2
Ercan U, Kiraz A, Çikman Ö, et al. The effect of systemic
carnitine administration on colon anastomosis healing in an
experimental sepsis model. J Invest Surg 2015; 28:334-40. doi:
10.3109/08941.939.2015.1029652
Fang AH, Chao W, Ecker M. Review of colonic anastomotic
leakage and prevention methods. J Clin Med 2020; 9:4061. doi:
10.3390/jcm9124061
Fathizadeh H, Milajerdi A, Reiner Ž, et al. The effects of
L-carnitine supplementation on indicators of inflammation
and oxidative stress: a systematic review and meta-analysis of
randomized controlled trials. J Diabetes Metab Disord 2020;
19:1879-94. doi: 10.1007/s40200.020.00627-9
Cronin K, Jackson DS, Dunphy JE. Changing bursting
strength and collagen content of the healling colon. Surg
Gynecal obstent 1968; 126 : 747 – 53.
Year 2023,
Volume: 36 Issue: 2, 215 - 222, 31.05.2023
Kirchhoff P, Clavien PA, Hahnloser D. Complications in
colorectal surgery: risk factors and preventive strategies.
Patient Saf Surg 2010; 4:5. doi: 10.1186/1754-9493-4-5
Ruiz-Tovar J, Morales-Castiñeiras V, Lobo-Martínez E.
Postoperative complicactions of colon surgery. Cir Cir 2010;
78:283-91.
Gülçin I. Antioxidant and antiradical activities of L-carnitine.
Life Sci 2006; 78:803-11. doi: 10.1016/j.lfs.2005.05.103
Kutluay Köklü AH, Küpeli Akkol E, Uğar Çankal DA.
Biochemical and biomechanical assessment of effects of
L-carnitine on oral mucosal wounds. Clin Oral Investig 2015;
19:1101-6. doi: 10.1007/s00784.014.1329-8
Bell FP, Vidmar TJ, Raymond TL. L-carnitine administration
and withdrawal affect plasma and hepatic carnitine
concentrations, plasma lipid and lipoprotein composition,
and in vitro hepatic lipogenesis from labeled mevalonate
in normal rabbits. J Nutr 1992; 122:959-66. doi: 10.1093/
jn/122.4.959
Arduini A. Carnitine and its acyl esters as secondary
antioksidants? Am Heart J 1992; 123:1726-7. doi:
10.1016/0002-8703(92)90850-u
Sabry MM, Ahmed MM, Maksoud OMA, et al. Carnitine,
apelin and resveratrol regulate mitochondrial quality control
(QC) related proteins and ameliorate acute kidney injury: role
of hydrogen peroxide. Arch Physiol Biochem 2020; 13:1-10.
doi: 10.1080/13813.455.2020.1773504
Zhao T, Chen S, Wang B, Cai D. L-Carnitine Reduces
Myocardial Oxidative Stress and Alleviates Myocardial
Ischemia-Reperfusion Injury by Activating Nuclear
Transcription-Related Factor 2 (Nrf2)/Heme Oxygenase-1
(HO-1) Signaling Pathway. Med Sci Monit 2020; 26:e923251.
doi: 10.12659/MSM.923251
Akkus A, Aydinuraz K, Daphan C, et al. Effect of carnitine on
cutaneous wound healing in immunosuppressed rats. J Surg
Res 2009; 155:301-5. doi: 10.1016/j.jss.2008.06.010
Choi BS, Song HS, Kim HR, et al. Effect of coenzyme Q10 on
cutaneous healing in skin-incised mice. Arch Pharm Res 2009;
32:907-13. doi: 10.1007/s12272.009.1613-3
Cakmak GK, Irkorucu O, Ucan BH, et al. The effects of
resveratrol on the healing of left colonic anastomosis. J Invest
Surg 2009(a); 22:353-61. doi: 10.1080/089.419.30903214701
Kabali B, Girgin S, Gedik E, Ozturk H, Kale E, Buyukbayram
H. N-Acetylcysteine prevents deleterious effects of ıschemia/
reperfusion ınjury on healing of colonic anastomosis in rats.
Eur Surg Res 2009; 43:8–12. doi: 10.1159/000210673
Cakmak GK, Irkorucu O, Ucan BH, et al. Simvastatin
improves wound strength after intestinal anastomosis in the
rat. J Gastrointest Surg 2009(b); 13:1707-16. doi: 10.1007/
s11605.009.0951-2
Kurahashi T, Fujii J. Roles of Antioxidative Enzymes in Wound
Healing. J Dev Biol 2015; 3:57-70. https://doi.org/10.3390/
jdb3020057
Xu Z, Han S, Gu Z, Wu J. Advances and Impact of Antioxidant
Hydrogel in Chronic Wound Healing. Adv Healthc Mater
2020; 9:e1901502. doi: 10.1002/adhm.201901502
Charan J, Kantharia ND. How to calculate sample size in
animal studies? J Pharmacol Pharmacother 2013; 4:303-6.
doi:10.4103/0976-500X.119726
Arifin WN, Zahiruddin WM. Sample Size Calculation in
Animal Studies Using Resource Equation Approach. Malays J
Med Sci 2017; 24:101-5. doi: 10.21315/mjms2017.24.5.11
Demir U, Edremitlioğlu M, Kandaş E, Şehitoğlu MH,
Kılınç N. Quercetin associated with dimethylsulfoxide
has a curative effect on experimental colon anastomosis
injury. Acta Cir Bras 2020; 35:e202000602. doi: 10.1590/
s0102.865.0202000.600.00002
Goel SA, Nagpal P, Nagarajan P, Panda A K, Chhabra HS.
Lateral approach to the lumbar spine of sprague dawley rat:
development of a novel animal model for spine surgery. Indian
Spine J 2019; 2:134-37.
Irvin TT, Hunt TK. Pathogenesis and prevention of disruption
of colonic anastomoses in traumatized rats. Br J Surg 1974;
61:437-39. doi: 10.1002/bjs.180.061.0605.
Yagi K. Assay of lipid peroxidation in blood plasma or serum.
Methods Enzymol 1984; 105: 328-31. doi: 10.1016/s0076-
6879(84)05042-4
Chiu CJ, McArdle AH, Brown R, Scott HJ, Gurd FN. Intestinal
mucosal lesion in low-flow states. I. A morphological,
hemodynamic, and metabolic reappraisal. Arch Surg 1970;
101:478-83. doi: 10.1001/archsurg.1970.013.40280030009
Poon P, Law WL, Chu KW, Wong J. Emergency resection and
primary anastomosis for left-sided obstructing colorectal
carcinoma in the elderly. Br J Surg 1998; 85:1539-42. doi:
10.1046/j.1365-2168.1998.00903.x
Thornton FJ, Barbul A. Healing in the gastrointestinal tract.
Surg Clin North Am 1997; 77: 549-73. doi: 10.1016/s0039-
6109(05)70568-5
Oines MN, Krarup PM, Jorgensen LN, Agren MS.
Pharmacological interventions for improved colonic
anastomotic healing: a meta-analysis. World J Gastroenterol
2014;20:12637-48. doi: 10.3748/wjg.v20.i35.12637.
Hensley K, Kotake Y, Sang H, et al. Dietary choline restriction
causes complex I dysfunction and increased H(2)O(2)
generation in liver mitochondria. Carcinogenesis 2000;
21:983-9. doi: 10.1093/carcin/21.5.983
Blokhina O, Virolainen E, Fagerstedt KV. Antioxidants,
oxidative damage and oxygen deprivation stress: a review.
Ann Bot 2003; 91:179-94. doi: 10.1093/aob/mcf118
Bayir H. Reactive oxygen species. Crit Care Med 2005; 33(12
Suppl):S498-501. doi: 10.1097/01.ccm.000.018.6787.64500.12
Yager DR, Kulina RA, Gilman LA. Wound fluids: a window
into the wound environment? Int J Low Extrem Wounds 2007;
6:262-72. doi: 10.1177/153.473.4607307035
Moradi M, Moradi A, Alemi M, et al. Safety and efficacy
of clomiphene citrate and L-carnitine in idiopathic male
infertility: a comparative study. Urology J 2010; 7:188-93.
doi:10.22037/UJ.V7I3.750
Kunnavatana SS, Quan SY, Koch RJ. Combined effect of
hyberbaric oxygen and N-acetylcysteine on fibroblast
proliferation. Arch Otolaryngol Head Neck Surg 2005;131:809-
14. doi: 10.1001/archotol.131.9.809
Broughton G II, Janis JE, Attinger CE. The basic science of
wound healing, Plast Reconstr Surg 2006;117: 12-34. doi:
10.1097/01.prs.000.022.5430.42531.c2
Ercan U, Kiraz A, Çikman Ö, et al. The effect of systemic
carnitine administration on colon anastomosis healing in an
experimental sepsis model. J Invest Surg 2015; 28:334-40. doi:
10.3109/08941.939.2015.1029652
Fang AH, Chao W, Ecker M. Review of colonic anastomotic
leakage and prevention methods. J Clin Med 2020; 9:4061. doi:
10.3390/jcm9124061
Fathizadeh H, Milajerdi A, Reiner Ž, et al. The effects of
L-carnitine supplementation on indicators of inflammation
and oxidative stress: a systematic review and meta-analysis of
randomized controlled trials. J Diabetes Metab Disord 2020;
19:1879-94. doi: 10.1007/s40200.020.00627-9
Cronin K, Jackson DS, Dunphy JE. Changing bursting
strength and collagen content of the healling colon. Surg
Gynecal obstent 1968; 126 : 747 – 53.
Kandas, E., Edremıtlıoglu, M., Demır, U., Erbıl, G., et al. (2023). Healing effects of L-carnitine on experimental colon anastomosis wound. Marmara Medical Journal, 36(2), 215-222. https://doi.org/10.5472/marumj.1307971
AMA
Kandas E, Edremıtlıoglu M, Demır U, Erbıl G, Sehıtoglu MH. Healing effects of L-carnitine on experimental colon anastomosis wound. Marmara Med J. May 2023;36(2):215-222. doi:10.5472/marumj.1307971
Chicago
Kandas, Emel, Mustafa Edremıtlıoglu, Ufuk Demır, Guven Erbıl, and Muserref Hilal Sehıtoglu. “Healing Effects of L-Carnitine on Experimental Colon Anastomosis Wound”. Marmara Medical Journal 36, no. 2 (May 2023): 215-22. https://doi.org/10.5472/marumj.1307971.
EndNote
Kandas E, Edremıtlıoglu M, Demır U, Erbıl G, Sehıtoglu MH (May 1, 2023) Healing effects of L-carnitine on experimental colon anastomosis wound. Marmara Medical Journal 36 2 215–222.
IEEE
E. Kandas, M. Edremıtlıoglu, U. Demır, G. Erbıl, and M. H. Sehıtoglu, “Healing effects of L-carnitine on experimental colon anastomosis wound”, Marmara Med J, vol. 36, no. 2, pp. 215–222, 2023, doi: 10.5472/marumj.1307971.
ISNAD
Kandas, Emel et al. “Healing Effects of L-Carnitine on Experimental Colon Anastomosis Wound”. Marmara Medical Journal 36/2 (May 2023), 215-222. https://doi.org/10.5472/marumj.1307971.
JAMA
Kandas E, Edremıtlıoglu M, Demır U, Erbıl G, Sehıtoglu MH. Healing effects of L-carnitine on experimental colon anastomosis wound. Marmara Med J. 2023;36:215–222.
MLA
Kandas, Emel et al. “Healing Effects of L-Carnitine on Experimental Colon Anastomosis Wound”. Marmara Medical Journal, vol. 36, no. 2, 2023, pp. 215-22, doi:10.5472/marumj.1307971.
Vancouver
Kandas E, Edremıtlıoglu M, Demır U, Erbıl G, Sehıtoglu MH. Healing effects of L-carnitine on experimental colon anastomosis wound. Marmara Med J. 2023;36(2):215-22.