Vitamin E offers notable benefits in surgical settings, primarily due to its antioxidant and anti-inflammatory properties. Its role in reducing oxidative stress helps modulate immune responses and limits tissue damage, aiding in faster recovery. Vitamin E, particularly in its tocopherol and tocotrienol forms, supports cell membrane stability and reduces lipid peroxidation, which are crucial for tissue repair and minimizing scar formation. Additionally, Vitamin E assists in secondary prevention of complications in cardiac surgery, including the prevention of atherosclerotic developments in coronary grafts. Its fat-soluble nature allows for prolonged presence in the body, making it valuable for sustained postoperative support. The administration of antioxidants, including vitamin E enhances bone healing by significantly increasing osteocalcin and alkaline phosphatase levels, elevating antioxidant enzyme activity, and reducing oxidative stress markers in plasma. 

Mechanisms of Action and Benefits:

• Antioxidant Function: Reduces oxidative stress, which limits cellular damage during and after surgery, supporting faster recovery and better outcomes by modulating immune response and decreasing inflammation. 
• Fluidity of Cell Membrane: Tocopherol and tocotrienol forms of Vitamin E stabilize cell membranes, minimizing damage and supporting cell integrity for effective tissue repair.
• Reduction of Lipid Peroxidation: Decreases lipid peroxidation, which is critical in minimizing scar formation and promoting healthy tissue regeneration. In cardiovascular surgeries, Vitamin E aids in the secondary prevention of atherosclerotic developments, particularly in coronary artery bypass grafts.
• Bone Healing Enhancement: Increases osteocalcin and alkaline phosphatase levels, boosting bone healing and repair postoperatively through antioxidant effects on oxidative stress markers.
• Fat-Soluble Storage: Its fat-soluble nature allows Vitamin E to remain active in the body over an extended period, making it useful for prolonged postoperative support and secondary prevention.

References:

1.  https://lpi.oregonstate.edu/mic/vitamins/vitamin-E    accessed 10/24
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. doi:10.1002/clc.22422
3. Baines, Malcolm; Shenkin, Alan. Use of antioxidants in surgery: a measure to reduce postoperative complications. Current Opinion in Clinical Nutrition and Metabolic Care 5(6):p 665-670, November 2002.
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. doi:10.1161/CIR.0000000000000182
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. doi:10.1177/0960327110374203