Vitamin E, a fat-soluble antioxidant, plays a central role in surgical recovery by protecting cell membranes, modulating inflammation, and reducing oxidative stress. It exists in eight isoforms, including tocopherols and tocotrienols, with α-tocopherol being the most biologically active form. In surgical settings, vitamin E contributes to tissue integrity, bone healing, and cardiovascular support, and may reduce complications related to oxidative injury. Its extended bioavailability due to fat solubility offers sustained postoperative benefits.

Mechanisms of Action and Benefits

1. Antioxidant Activity and Inflammatory Modulation
Vitamin E neutralizes reactive oxygen species and inhibits lipid peroxidation,
helping to reduce oxidative stress induced by surgery. This modulation of the inflammatory cascade may improve postoperative recovery and reduce complications【1,3】.

2. Cell Membrane Protection and Tissue Repair
Vitamin E, particularly in its tocopherol and tocotrienol forms, helps stabilize phospholipid bilayers, maintaining cell membrane integrity and fluidity. This stabilization supports tissue regeneration, minimizes scar formation, and protects against cellular damage during surgical healing【1,2】.

3. Cardiovascular Protection in Surgery
Vitamin E contributes to secondary prevention in cardiovascular surgery,
including coronary artery bypass grafts, by limiting oxidative damage to vascular endothelium and reducing the risk of atherosclerotic developments in
grafts【2,4】.

4. Bone Healing Enhancement
Vitamin E enhances bone repair postoperatively by increasing osteocalcin andalkaline phosphatase levels. It also elevates antioxidant enzyme activity and
decreases oxidative stress markers, supporting bone remodeling and reducing
complications in orthopedic procedures【5】.

5. Prolonged Postoperative Support
Due to its fat-soluble nature, vitamin E remains in tissues longer than
water-soluble antioxidants. This enables extended protection from oxidative
stress during the entire postoperative period, making it valuable for sustained
surgical recovery support【1】.

References

1. Linus Pauling Institute. Vitamin E. Oregon State University. https://lpi.oregonstate.edu/mic/vitamins/vitamin-E. Accessed October 2024.
2. Mathur P, Ding Z, Saldeen T, Mehta JL. Tocopherols in the Prevention and Treatment of Atherosclerosis and Related Cardiovascular Disease. Clin Cardiol. 2015;38(9):570-576.
3. Baines M, Shenkin A. Use of antioxidants in surgery: a measure to reduce postoperative complications. Curr Opin Clin Nutr Metab Care. 2002;5(6):665-670.
4. Kulik A, Ruel M, Jneid H, et al. Secondary prevention after coronary artery bypass graft surgery: a scientific statement from the American Heart Association. Circulation. 2015;131(10):927-964.
5. Sandukji A, Al-Sawaf H, Mohamadin A, Alrashidi Y, Sheweita SA. Oxidative stress and bone markers in plasma of patients with long-bone fixative surgery: role of antioxidants. Hum Exp Toxicol. 2011;30(6):435-442.