ROLE OF CHYMOTRYPSIN IN POST-OPERATIVE WOUND MANAGEMENT IN PATIENTS UNDERGOING ELECTIVE INGUINAL HERNIA REPAIR SURGERIES

Authors

  • A FAROOQI Department Of general surgery unit 5 DUHS-CHK,karachi, Pakistan
  • F ZAHEER Department Of Surgical unit V , CHK Dow university of health sciences Karachi, Pakistan
  • S ABBAS Department of surgery Baqai medical university, Karachi, Pakistan
  • SN SHAIKH Department Of General Surgery,Civil,DUHS,Karachi, Pakistan
  • . SADIA Department of General Surgery, DUHS,Dr Ruth K. M. Pfau Civil Hospital,Karachi, Pakistan
  • S SALMAN Department of General Surgery,DUHS-CHK,Karachi, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.961

Keywords:

Hernia repair, Chymotrypsin, Seroma, hematoma, SSI

Abstract

This study aimed to evaluate the effectiveness of chymotrypsin and trypsin in improving post-operative wound management outcomes in patients undergoing inguinal hernia repair. Methods: An open-label randomised control trial was conducted at the Department of General Surgery, Ruth PFAU Civil Hospital Dow University of Health Sciences, Karachi. A total of 48 patients undergoing elective inguinal hernia surgery were included and randomly assigned to either Group A (placebo) or Group B (intervention). Group B received chymotrypsin (6 mg) and trypsin (1 mg) post-operatively for seven days. Outcome measures included oedema, hematoma, seroma, surgical site infection (SSI), pain scores, and duration of hospital stay. Data were analysed using SPSS version 21, with significance at P ≤ 0.05. Results: The mean age was higher in Group B (38.5 ± 11.1 years) than in Group A (33.91 ± 8.9 years) (P = 0.01). Group B had significantly lower incidences of oedema (42% vs 71%, P = 0.042), hematoma (21% vs 42%, P = 0.009), and seroma (11 vs 20, P = 0.007) compared to Group A. Although SSI rates were lower in Group B (25%) compared to Group A (50%), this difference was not statistically significant (P = 0.068). Pain scores were significantly lower in Group B (2.625 ± 0.7) compared to Group A (5.125 ± 0.7) (P < 0.0001). The duration of hospital stay was also shorter in Group B (3.75 ± 0.8 days) than in Group A (6.9 ± 1.08 days) (P < 0.0001). Conclusion: Chymotrypsin and trypsin significantly enhance post-operative recovery by reducing oedema, hematoma, seroma, pain scores, and hospital stay duration in inguinal hernia repair patients. These findings support incorporating enzymatic agents into post-operative care protocols to improve patient outcomes.

Downloads

Download data is not yet available.

References

Köckerling F, Hoffmann H, Mayer F, Zarras K, Reinpold W, Fortelny R, et al. What are the trends in incisional hernia repair? Real-world data over 10 years from the Herniamed registry. Hernia. 2021;25:255-65.

Ashley T, Ashley H, Wladis A, Bolkan HA, van Duinen AJ, Beard JH, et al. Outcomes after elective inguinal hernia repair performed by associate clinicians vs medical doctors in Sierra Leone: a randomized clinical trial. JAMA network open. 2021;4(1):e2032681-e.

Stryja J, Sandy-Hodgetts K, Collier M, Moser C, Ousey K, Probst S, et al. Surgical site infection: Prevention and management across health-care sectors. Journal of wound care. 2020;29(Sup2b):S1-S72.

Avila‑Rodríguez MI, Meléndez‑Martínez D, Licona‑Cassani C, Aguilar‑Yañez JM, Benavides J, Sanchez ML. Practical context of enzymatic treatment for wound healing: A secreted protease approach. Biomedical reports. 2020;13(1):3-14.

Vreeke GJ, Vincken J-P, Wierenga PA. The path of proteolysis by bovine chymotrypsin. Food Research International. 2023;165:112485.

Arnhold J. Host-derived cytotoxic agents in chronic inflammation and disease progression. International Journal of Molecular Sciences. 2023;24(3):3016.

Cazander G, den Ottelander BK, Kamga S, Doomen MC, Damen TH, van Well AME. Importance of Debriding and Wound Cleansing Agents in Wound Healing. Therapeutic Dressings and Wound Healing Applications. 2020:59-89.

Jadhav SB, Shah N, Rathi A, Rathi V, Rathi A. Serratiopeptidase: Insights into the therapeutic applications. Biotechnology Reports. 2020;28:e00544.

Lu Y, Chen DC, MacQueen IT. General surgery: management of postoperative complications following ventral hernia repair and inguinal hernia repair. Surgical Clinics. 2021;101(5):755-66.

Hersh EV, Moore PA, Grosser T, Polomano RC, Farrar JT, Saraghi M, et al. Nonsteroidal anti-inflammatory drugs and opioids in postsurgical dental pain. Journal of dental research. 2020;99(7):777-86.

Zulkefli N, Che Zahari CNM, Sayuti NH, Kamarudin AA, Saad N, Hamezah HS, et al. Flavonoids as potential wound-healing molecules: Emphasis on pathways perspective. International journal of molecular sciences. 2023;24(5):4607.

Sreesha S, Ummar M, Sooraj S, Aslam S, Roshni A, Jabir K. Postoperative pain, edema and trismus following third molar surgery–A comparitive study between submucosal and intravenous dexamethasone. Journal of Family Medicine and Primary Care. 2020;9(5):2454-9.

Zaheer F, Baloch Q, Abbas S, Naseer S, Muhammad O, Anees A, editors. Single Dose of IV Tranexamic Acid Preoperatively Reduces the Incidence of Post-Operative Scrotal Edema Following Lichtenstein Hernioplasty. A Randomized Prospective Cohort Analysis. Medical Forum Monthly; 2021.

Stabilini C, van Veenendaal N, Aasvang E, Agresta F, Aufenacker T, Berrevoet F, et al. Update of the international HerniaSurge guidelines for groin hernia management. BJS open. 2023;7(5):zrad080.

Kondreddy S, Palli S. Proteases and tissue repair: Peri operative role of chymotrypsin: Trypsin in surgical patients. International Surgery Journal. 2019;6(1):283-6.

Chandanwale A, Langade D, Sonawane D, Gavai P. A randomized, clinical trial to evaluate efficacy and tolerability of trypsin: chymotrypsin as compared to serratiopeptidase and trypsin: bromelain: rutoside in wound management. Advances in therapy. 2017;34:180-98.

Wortinger A. 9 The Postoperative Patient. Small Animal Surgical Nursing-E-Book. 2016:209.

Thomas DC, Tsu CL, Nain RA, Arsat N, Fun SS, Lah NASN. The role of debridement in wound bed preparation in chronic wound: A narrative review. Annals of medicine and surgery. 2021;71:102876.

Hashem AAR, Abd El Sattar AA, Rahman TYA. The effect of trypsin-chymotrypsin on postoperative pain after single visit endodontic treatment: a randomized controlled trial. Journal of Endodontics. 2023;49(3):240-7.

Downloads

Published

2024-07-13

How to Cite

FAROOQI, A., ZAHEER, F., ABBAS, S., SHAIKH, S., SADIA, ., & SALMAN, S. (2024). ROLE OF CHYMOTRYPSIN IN POST-OPERATIVE WOUND MANAGEMENT IN PATIENTS UNDERGOING ELECTIVE INGUINAL HERNIA REPAIR SURGERIES. Biological and Clinical Sciences Research Journal, 2024(1), 961. https://doi.org/10.54112/bcsrj.v2024i1.961

Most read articles by the same author(s)

1 2 > >>