eP394 Efficacy of Trypsin and Chymotrypsin in Accelerating Postoperative Recovery and Reducing Pain and Edema: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Aims and Objectives Postoperative pain and edema are common surgical challenges, often delaying recovery and impairing patient outcomes. This systematic review and meta-analysis evaluated the efficacy of trypsin-chymotrypsin (TC) in reducing recovery time, managing edema, and enhancing vascular protection. TC was compared with bromelain combinations and serratiopeptidase to identify superior postoperative outcomes. Methods A comprehensive database search (1961–2016) followed the PICO framework, comparing TC with placebo or other enzyme treatments. Outcomes included postoperative pain, edema resolution, recovery time, and analgesic use. A random-effects meta-analysis assessed effect sizes, with heterogeneity measured using I² statistics. Results Eleven randomized controlled trials (1,061 patients: TC, n=539; comparator, n=522) were analyzed. TC significantly reduced postoperative pain and edema, accelerated recovery (up to 50%), and decreased analgesic use compared to controls. Edema resolution improved within 48 hours post-injury. The meta-analysis showed an overall effect size of 0.545 (95% CI: 0.468–0.622, p < 0.0001), with moderate to high heterogeneity (I² = 74.8%). TC outperformed bromelain, rutoside, trypsin, and serratiopeptidase combinations, particularly in recovery time and vascular protection. Conclusion TC effectively reduces recovery time, postoperative pain, and edema, offering a superior alternative to bromelain, trypsin, rutoside, and serratiopeptidase. Its synergistic anti-inflammatory and proteolytic effects enhance edema resolution and vascular protection, making it a valuable option in postoperative care. These findings support TC's use as a therapeutic intervention to optimize recovery and improve patient outcomes following surgery.