CME

15/06/2022
Summary Systemic enzyme therapy with
Trypsin, Bromelain and Rutoside
MODERATOR in Post Operative Cases SPEAKER

Aims of Post Surgical Wound Care:

• Rapid healing Dr. Rajesh Dhadiwal
Dr. Girish Bakhshi
MBBS, MS - Surgery • Prevention of complications MBBS, DNB (Orthopaedics),

Professor & Head of Unit 2, • Best functional and aesthetic results Diploma in Orthopaedics,
Department of Surgery MNAMS (Membership of the National Academy)
Grant Government Medical College FIJS (Fellow in Joint Replacement Surgery)
& Sir J. J Group of Hospitals FIAS (Fellow in Arthroscopy Surgery)

Local factors Systemic factors

• Edema • Age
Factors affecting • Pressure - if excessive / sustained • Body type- obesity, emaciation
wound healing • Infection • Chronic diseases
• Maceration / Necrotic tissue • Immunosuppression
• Desiccation • Vascular insufficiency

Efficacy limitations: Safety concerns:

• Effect limited to COX inhibition • Gastro-intestinal irritation

Limitations with • Negative impact on wound healing • Renal disturbances
use of NSAIDs • Cardiovascular events
• Potential hepatotoxicity

• Trypsin, Bromelain, Rutoside combination has been shown to

increase the absorption of antibiotics
Enhanced antibiotic
penetration with • The ↑ absorption - primarily driven by the Bromelain component
Trypsin, Bromelain
& Rutoside • This action has been reported with multiple antibiotics and with different routes
of application including subcutaneous and intramuscular routes

Most perceived • Reduction of edema promote healing

clinical benefit • Pain management
with Trypsin, • Enhanced perfusion better healing
Bromelain & Rutoside • Help in penetration of antibiotics infection prevention

Barsom S, Sasse-Rollenhagen K, Betrmann A. Erfolgreiche Prostatitisbehandlung mit hydrolytischen Enzymen. (Effects of simultaneously administered Hydrolytic enzymes on
Antibiotic serum levels). Erfahrungsheilkunde1982;31:2
 CME
15/06/2022
Summary
Comparison of mechanisms of
Systemic enzyme therapy with
Trypsin, Bromelain and Rutoside

Multi-pronged action of Trypsin, Bromelain and Rutoside

Limited action of Trypsin-Chymotrypsin on pathophysiology

Take-home message
• Systemic anti-inflammatory enzymes – multi-pronged action
• The ↑ absorption of antibiotics - primarily driven by the Bromelain component in Trypsin, Bromelain, Rutoside combination
• Advantages of Trypsin, Bromelain, Rutoside over NSAIDs and Trypsin/Chymotrypsin include:
= Inhibition of kinin system ↓ prostaglandins pain reduction
= Inhibition of secondary vasodilatation  further edema prevention better healing
= Reduction of inflammatory cytokines early achievement of homeostasis
= Scavenging of oxygen radicals less tissue damage
 Link to CME and full length article
on Management of Post Surgical inflammation
with systemic enzyme therapy

To access the CME Systemic enzyme therapy with

Trypsin, Bromelain and Rutoside in post operative cases
please click on the youtube link. https://youtu.be/nU75ViIZ4Wc

To access the full length article of

‘Management of Post- Surgical inflammation with
Proteolytic enzyme –bioflavonoid combination’
Dhadiwal, Rajesh & Tiwari, Shashank & Jauhari, Ramendra.
(2021) International Journal of Scientific Research.
34-37. 10.36106/ijsr/0603723.
Please click on the link below:
https://www.worldwidejournals.com/
international-journal-of-scientific-research-(IJSR)/article/
management-of-post-surgical-inflammation-with-proteolytic-enzyme-
bioflavonoid-combination/MzY0ODA=/?is=1&b1=1253&k=314
 An Aksigen Initiative

In Post Operative Cases:

When excessive inflammation & edema leads to
> Delayed wound healing
> Infective complications
> Increased length of hospital stay

Only dispersible enzyme trio…. Ensures faster recovery

1
st
DCGI APPROVED BRAND
1

Trypsin, Bromelain & Rutoside

Trypsin, Bromelain & Rutoside

provides potent control and resolution of post-operative inflammation

> Multi- pronged action on different inflammatory processes

> Hastens the recovery by reducing edema
> Aids wound healing
> Better safety profile