Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Endopeptidases, such as bromelain (from pineapple) and serratiopeptidase, are proteolytic enzymes sometimes used as adjuncts in post-surgical healing. The rationale is that these enzymes can help degrade inflammatory mediators and fibrin, thus reducing edema, bruising, and pain, and potentially accelerating recovery. Clinical studies, primarily with bromelain and serratiopeptidase, have shown modest benefits in reducing swelling and discomfort in various surgical contexts, such as dental surgery and orthopedic procedures. For example, several small randomized trials have reported reduced post-operative swelling and pain when bromelain is administered orally compared to placebo. However, the evidence base remains limited by small sample sizes, variable study quality, and inconsistent results. Systematic reviews generally conclude that while there is some evidence for benefit, it is not robust, and more high-quality, large-scale trials are needed to establish efficacy and safety definitively. Regulatory bodies have not universally endorsed endopeptidases for routine post-surgical care, and their use remains somewhat controversial. In summary, there is preliminary scientific support for the use of endopeptidases in post-surgical healing, but the overall quality and quantity of evidence are modest, justifying a moderate evidence rating.

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