Systemic Enzymes & Postoperative Recovery

Although surgery is often a necessary part of therapy in some cases, aesthetic surgery comes with many of the same complications and concerns as necessary surgery. Surgical incision initiates a complex series of regulatory events that can inhibit a proper healing response, while promoting infection, pain and loss of function depending on the circumstances. Orthopedic procedures often pose threat of blood clotting, while facial reconstructive surgery often causes severe edema and swelling. Surgeries involving implantation always run the risk of infection, although the incidence has greatly been reduced due to sanitary regulations. The formation of scar tissue can restrict movement, and even prevent desired results of aesthetic surgery.

The use of therapeutic, orally administered proteolytic enzymes in surgery is a useful, yet often overlooked remedy. Their potent anti-inflammatory and anti-edema effects can speed recovery time and promote normal function post-surgery. Breaking down scar tissue and regulating inflammation reduce prolonged postoperative pain and discomfort. The benefits of systemic enzymes are well documented, but since they are considered an alternative therapy, many doctors are unaware of the assistance enzymes offer.

In a study conducted on patients receiving hand surgery, researchers noted that the use of orally administered proteolytic enzymes was useful when added to standard post-operative regimen due to their inhibitory effects on edema. This clinical appraisal based on objective measurements and carried out on a double blind basis.*

A study conducted in 1999 details the beneficial effects of systemic enzymes following aesthetic surgery. Defined as having pharmacological effects, representing preventative and curative options for inflammatory processes and healing – systemic enzymes are documented as providing excellent results in postoperative patients. Patients who had received upper eyelid blepharoplasty (correction of the eyelid) experienced decreased edema and pain following oral administration of proteolytic enzymes. No undesirable side effects were observed, and there were no limitations for patients with cardiovascular, hepatic or renal risks.*

Proteolytic enzymes’ ability to directly affect localized inflammation is further demonstrated in a study published in the International Journal of Oral and Maxillofacial Surgery. Enzyme efficacy was evaluated based on reduction of postoperative swelling, pain and trismus (spasms of the jaw muscle) after third molar removal. A significant reduction was seen in both cheek thickness and pain intensity in patients receiving enzyme therapy.*

The American Society of Plastic Surgeons has also published studies detailing the benefits of proteolytic enzymes – this time in nasal plastic surgery.*

Especially in surgeries involving implantation, infection is an unfavorable complication. A 2006 study examined the effects of serrapeptase, a proteolytic enzyme, on the eradication of infection after implantation. Serrapeptase is noted as being effective in the eradication of infection caused by bio-film forming bacteria. Anti-biofilm properties of serrapeptase make it useful in the prevention of infection post-operation.*

The surgical benefits of proteolytic enzymes have also been documented in episiotomy (surgical incision during the second stage of labor). The double blind clinical trial documents a reduction in bruising and edema in patients receiving enzyme therapy.*


Lie K, Larsen R, Posch J. Therapeutic Value of Oral Proteolytic Enzymes Following Hand Surgery. JAMA Surgery 1969. 98(1).

Duskova M, Wald M. Orally Administered Proteases in Aesthetic Surgery. Aesthetic Plastic Surgery 1999. 23(1):41-44.

Al-Khateeb TH, Nusair Y. Effect of the Proteolytic Enzyme Serrapeptase on Swelling, Pain and Trismus after Surgical Extraction of Mandibular Third Molars. International Journal of Oral and Maxillofacial Surgery. 37(3): 264-268.

Kahn S. The Use of Proteolytic Enzymes from Carica Papaya in Nasal Plastic Surgery. Plastic and Reconstructive Surgery 1965. 35(4):428-432.

Mecikoglu M, Saygi B, Yildirim Y, et al. The Effect of Proteolytic Enzyme Serratiopeptidase in the Treatment of Experimental Implant-Related Infection. The Journal of Bone and Joint Surgery 2006. 88(6):1208-1214.

Howat RCL, Lewis GD. The Effect of Bromelain Therapy on Episiotomy Wounds – A Double Blind Controlled Clinical Trial. BJOG: An International Journal of Obstetrics and Gynaecology 2005. 79(10):951-953.


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