Effect of Oral Bromelain on Wound Healing, Pain, and Bleeding at Donor Site Following Free Gingival Grafting: A Clinical Trial.

Sara Soheilifar, Mohsen Bidgoli, Amirarsalan Hooshyarfard, Armaghan Shahbazi, Farshid Vahdatinia, Fahime Khoshkhooie
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Abstract

Objectives: Considering the optimal efficacy of bromelain for pain relief and wound healing, this study aimed to assess the effect of bromelain on wound healing, pain, and bleeding at the donor site following free gingival grafting (FGG).

Materials and methods: This randomized, controlled double-blind clinical trial was performed on 26 patients with gingival recession. The patients were randomly divided into two groups of bromelain and placebo (n=13). Treatment was started on the day of surgery and was continued for 10 days. Pain, bleeding, and epithelialization at the donor site were the variables evaluated in this study using a questionnaire. The level of pain was determined using a visual analog scale (VAS) considering the number of analgesic tablets taken within 7 days postoperatively. Bleeding was determined according to the patient's report, and epithelization was assessed by applying 3% hydrogen peroxide (H2O2) to the donor site. The donor site epithelialization was assessed at 7 and 10 days after surgery.

Results: Bromelain caused a significant reduction in pain at the donor site (2.605±0.509) compared to the placebo (4.885±0.519; P<0.05). The number of donor sites with complete epithelialization was higher in the bromelain group compared to the placebo, but this difference was not statistically significant (P>0.05). The two groups were the same regarding postoperative bleeding (P>0.05).

Conclusions: The results showed that oral bromelain (500 mg/day) can be effective in the reduction of pain at the donor site after FGG and may also enhance wound healing. Oral bromelain does not increase the risk of postoperative bleeding.

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口服菠萝蛋白酶对游离牙龈移植后供区伤口愈合、疼痛和出血的影响:一项临床试验。
目的:考虑到菠萝蛋白酶缓解疼痛和创面愈合的最佳效果,本研究旨在评估菠萝蛋白酶对游离牙龈移植(FGG)后供区创面愈合、疼痛和出血的影响。材料与方法:对26例牙龈萎缩患者进行随机对照双盲临床试验。患者随机分为菠萝蛋白酶组和安慰剂组(n=13)。手术当天开始治疗,持续10天。在本研究中,通过问卷调查评估了供体部位的疼痛、出血和上皮化。采用视觉模拟评分法(VAS),结合术后7天内服用镇痛片的数量来确定疼痛程度。根据患者报告确定出血,并通过在供体部位涂抹3%过氧化氢(H2O2)来评估上皮情况。在术后7天和10天评估供体部位上皮化情况。结果:与安慰剂组(4.885±0.519)相比,菠萝蛋白酶可显著减少供区疼痛(2.605±0.509);P0.05)。两组术后出血情况相同(P>0.05)。结论:口服菠萝蛋白酶(500mg /d)可有效减轻FGG术后供区疼痛,促进创面愈合。口服菠萝蛋白酶不会增加术后出血的风险。
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