Synopsis

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

Proteolytic enzymes (proteases) such as bromelain, trypsin, and chymotrypsin have been investigated for their potential to support healing after surgery. The rationale for their use is based on their ability to break down protein-based debris, reduce inflammation, and modulate immune responses, which could theoretically accelerate recovery and decrease swelling and pain. Several small clinical studies and meta-analyses suggest that proteolytic enzymes may reduce postoperative swelling, pain, and hematoma formation, particularly after oral, dental, and some orthopedic surgeries. For example, a 2012 systematic review found modest benefits in reducing swelling and discomfort after wisdom tooth extraction when bromelain was used. However, the overall quality of evidence is mixed, with many studies being small, lacking rigorous controls, or having a high risk of bias. Major medical guidelines do not endorse routine use of proteolytic enzymes for surgical healing due to insufficient high-quality evidence and some concerns about potential side effects, such as increased bleeding risk. In summary, while there is some scientific evidence to support their use, it is limited and not robust; more large, well-controlled clinical trials are needed to confirm efficacy and safety in the context of postoperative recovery.

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