The effect of using pineapple fresh juice to improve post-surgical pain, ecchymosis and swelling in maxillofacial region
Abstract
Background: Facial plastic surgeries are usually associated with various post-surgical undesirable symptoms, particularly pain, Swelling, and ecchymosis. Depending on the nature of the procedures, these symptoms could last for days, sometimes over a week or more. Considering the optimal efficacy of Bromelain, this study is used to justify the benefits of pre-operative use of Bromelain found in pineapple using fresh pineapple juice to reduce such complications. Materials and Methods: A randomized clinical study was performed among 100 patientsundergoing various facial surgical operations; the patients were randomly divided into two groups; fifty patients received the pre-operative fresh pineapple juice (350ml glass) twice every day, a week before and continued for seven days after surgery. The pain level was determined using a visual analog scale, Swelling, and ecchymosis judged by visual inspection. Average scores for all symptoms were added to obtain the clinical sum score for each visit. Results: Pre-operative use of fresh pineapple juice was significantly reduced post-surgical pain, swelling, and ecchymosis with statistically significant results (p<0.005) in each pineapple groups. Conclusion: Bromelain found in pineapple fruit can be used as a successful therapy before various facial surgical procedures to minimize and provide faster recovery from undesirable post-operative symptoms. Keywords: Facial surgeries; Bromelain; Pineapple juice; Wound healing; Complications.
1. Ho D, Jagdeo J, Waldorf HA. Is There a Role for Arnica and Bromelain in Prevention of Post-Procedure Ecchymosis or Edema? A Systematic Review of the Literature. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al]. 2016;42(4):445-63.
2. Ong AA, Farhood Z, Kyle AR,et al. Interventions to Decrease Postoperative Edema and Ecchymosis after Rhinoplasty: A Systematic Review of the Literature. Plastic and reconstructive surgery. 2016;137(5):1448-62.
3. Kaur H, Corscadden K, Lott C, et al. Bromelain has paradoxical effects on blood coagulability: a study using thromboelastography. Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis. 2016;27(7):745-52.
4. Seamont D, Vrcek I, Nakra T, et al. Arnica and Bromelain for Blepharoplasty-Associated Ecchymosis. The American Journal of Cosmetic Surgery. 2017;35(3):130-4.
5. Gaspani L, Limiroli E, Ferrario P, et al. In vivo and in vitro effects of bromelain on PGE(2) and SP concentrations in the inflammatory exudate in rats. Pharmacology. 2002;65(2):83-6.
6. Pavan R, Jain S, Shraddha, Kumar A. Properties and therapeutic application of bromelain: a review. Biotechnol Res Int. 2012;2012:976203-.
7. Matschke R, Zeman F, Huppertz G, Koller M, Meiser P. Therapeutic Applications and Benefits from Postsurgical Use of the Phytotherapeutic Bromelain in Otorhinolaryngology: A Non- Interventional Study. Otolaryngology: Open Access. 2017;07.
8. Howat RCL, Lewis GD. The effect of bromelain therapy on episiotomy wounds—a double blind controlled clinical trial. Bjog: An International Journal of Obstetrics & Gynaecology. 1972;79(10):951-3.
9. Bhattacharyya BK, editor Bromelain: An Overview. Nat. Prod. Radiance.2008;7(4):359-365.
10. Seltzer AP. A double-blind study of bromelains in the treatment of edema and ecchymoses following surgical and nonsurgical trauma to the face. Eye, ear, nose & throat monthly. 1964;43:54-7.
11. Lotz-Winter H. On the pharmacology of bromelain: an update with special regard to animal studies on dose-dependent effects. Planta medica. 1990;56(3):249-53.
12. Brien S, Lewith G, Walker A, et al. Bromelain as a Treatment for Osteoarthritis: a Review of Clinical Studies. Evidence-based complementary and alternative medicine : eCAM. 2004;1(3):251-7.
13. Rowan AD, Buttle DJ. Pineapple cysteine endopeptidases. Methods in enzymology. 1994;244:555-68.
14. Tochi B, Zhang W, Xu S, et al. Therapeutic Application of Pineapple Protease (Bromelain): A Review. Pakistan Journal of Nutrition. 2008;7.
15. Bormann KH, Weber K, Kloppenburg H, et al. Perioperative Bromelain Therapy after Wisdom Teeth Extraction - A Randomized, Placebo-Controlled, Double-Blinded, Three-Armed, Cross-Over Dose-Finding Study. Phytotherapy research : PTR. 2016;30(12):2012-9.
16. Seltzer AP. Minimizing post-operative edema and ecchymoses by the use of an oral enzyme preparation (bromelain). A controlled study of 53 rhinoplasty cases. Eye, ear, nose & throat monthly. 1962;41:813-7.
17. Walker AF, Bundy R, Hicks SM,et al. Bromelain reduces mild acute knee pain and improves well-being in a dose-dependent fashion in an open study of otherwise healthy adults. Phytomedicine : international journal of phytotherapy and phytopharmacology. 2002;9(8):681-6.
18. Maurer HR. Bromelain: biochemistry, pharmacology and medical use. Cellular and molecular life sciences : CMLS. 2001;58(9):1234-45.
19. G. Klein;W. Kullich. Short-Term Treatment of Painful Osteoarthritis of the Knee with Oral Enzymes: A Randomised, Double-Blind Study versus Diclofenac. Clinical Drug Investigation. 2000;19:15-23.
20. Kotlus BS, Heringer DM, Dryden RM. Evaluation of homeopathic Arnica montana for ecchymosis after upper blepharoplasty: a placebo-controlled, randomized, double-blind study. Ophthalmic plastic and reconstructive surgery. 2010;26(6):395-7.
21. Chaiet SR, Marcus BC. Perioperative Arnica montana for Reduction of Ecchymosis in Rhinoplasty Surgery. Annals of plastic surgery. 2016;76(5):477-82.
2. Ong AA, Farhood Z, Kyle AR,et al. Interventions to Decrease Postoperative Edema and Ecchymosis after Rhinoplasty: A Systematic Review of the Literature. Plastic and reconstructive surgery. 2016;137(5):1448-62.
3. Kaur H, Corscadden K, Lott C, et al. Bromelain has paradoxical effects on blood coagulability: a study using thromboelastography. Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis. 2016;27(7):745-52.
4. Seamont D, Vrcek I, Nakra T, et al. Arnica and Bromelain for Blepharoplasty-Associated Ecchymosis. The American Journal of Cosmetic Surgery. 2017;35(3):130-4.
5. Gaspani L, Limiroli E, Ferrario P, et al. In vivo and in vitro effects of bromelain on PGE(2) and SP concentrations in the inflammatory exudate in rats. Pharmacology. 2002;65(2):83-6.
6. Pavan R, Jain S, Shraddha, Kumar A. Properties and therapeutic application of bromelain: a review. Biotechnol Res Int. 2012;2012:976203-.
7. Matschke R, Zeman F, Huppertz G, Koller M, Meiser P. Therapeutic Applications and Benefits from Postsurgical Use of the Phytotherapeutic Bromelain in Otorhinolaryngology: A Non- Interventional Study. Otolaryngology: Open Access. 2017;07.
8. Howat RCL, Lewis GD. The effect of bromelain therapy on episiotomy wounds—a double blind controlled clinical trial. Bjog: An International Journal of Obstetrics & Gynaecology. 1972;79(10):951-3.
9. Bhattacharyya BK, editor Bromelain: An Overview. Nat. Prod. Radiance.2008;7(4):359-365.
10. Seltzer AP. A double-blind study of bromelains in the treatment of edema and ecchymoses following surgical and nonsurgical trauma to the face. Eye, ear, nose & throat monthly. 1964;43:54-7.
11. Lotz-Winter H. On the pharmacology of bromelain: an update with special regard to animal studies on dose-dependent effects. Planta medica. 1990;56(3):249-53.
12. Brien S, Lewith G, Walker A, et al. Bromelain as a Treatment for Osteoarthritis: a Review of Clinical Studies. Evidence-based complementary and alternative medicine : eCAM. 2004;1(3):251-7.
13. Rowan AD, Buttle DJ. Pineapple cysteine endopeptidases. Methods in enzymology. 1994;244:555-68.
14. Tochi B, Zhang W, Xu S, et al. Therapeutic Application of Pineapple Protease (Bromelain): A Review. Pakistan Journal of Nutrition. 2008;7.
15. Bormann KH, Weber K, Kloppenburg H, et al. Perioperative Bromelain Therapy after Wisdom Teeth Extraction - A Randomized, Placebo-Controlled, Double-Blinded, Three-Armed, Cross-Over Dose-Finding Study. Phytotherapy research : PTR. 2016;30(12):2012-9.
16. Seltzer AP. Minimizing post-operative edema and ecchymoses by the use of an oral enzyme preparation (bromelain). A controlled study of 53 rhinoplasty cases. Eye, ear, nose & throat monthly. 1962;41:813-7.
17. Walker AF, Bundy R, Hicks SM,et al. Bromelain reduces mild acute knee pain and improves well-being in a dose-dependent fashion in an open study of otherwise healthy adults. Phytomedicine : international journal of phytotherapy and phytopharmacology. 2002;9(8):681-6.
18. Maurer HR. Bromelain: biochemistry, pharmacology and medical use. Cellular and molecular life sciences : CMLS. 2001;58(9):1234-45.
19. G. Klein;W. Kullich. Short-Term Treatment of Painful Osteoarthritis of the Knee with Oral Enzymes: A Randomised, Double-Blind Study versus Diclofenac. Clinical Drug Investigation. 2000;19:15-23.
20. Kotlus BS, Heringer DM, Dryden RM. Evaluation of homeopathic Arnica montana for ecchymosis after upper blepharoplasty: a placebo-controlled, randomized, double-blind study. Ophthalmic plastic and reconstructive surgery. 2010;26(6):395-7.
21. Chaiet SR, Marcus BC. Perioperative Arnica montana for Reduction of Ecchymosis in Rhinoplasty Surgery. Annals of plastic surgery. 2016;76(5):477-82.
| Files | ||
| Issue | Vol 8, No 2 (Spring 2021) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/jcr.v8i2.7644 | |
| Keywords | ||
| Facial surgeries; Bromelain; Pineapple juice; Wound healing; Complications. | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Mahmood B. The effect of using pineapple fresh juice to improve post-surgical pain, ecchymosis and swelling in maxillofacial region. J Craniomaxillofac Res. 2021;8(2):67-75.
