Systemic enzyme therapy in the treatment and prevention of post-traumatic and postoperative swelling
Kamenícek V, Holán P, Franĕk P. Systemic enzyme therapy in the
treatment and prevention of post-traumatic and postoperative
swelling. Acta Chir Orthop Traumatol Cech. 2001;68(1):45-49. Article
in Czech.
Chirurgické oddĕlení nemocnice, Bílovec.
PURPOSE OF THE STUDY: The authors concentrate on the use of enzyme
therapy intraumatology. They monitored SET efficiency in the
treatment and prophylazis of swelling in the postoperative period
after the internal fixation of fractures of long bones and compared
it with the effect of standard antiswelling seu antioedematous drugs
on the basis of aescin.
MATERIAL: A group of 60 patients was followed after the fixation of
long bones. The average age was 42 years (range,12-79 years).
Fractures were treated by intrameduilary fixation or by external
fixators. The patients were split into two groups. In 30 patients
only Phlogenzym was administered for the treatment and prevention of
posttraumatic and postoperative swelling. Another 30 patients--the
control group--were treated by standard antioedematic drugs on the
basis of aescin. The same analgesics were applied in both groups.
METHODS: The group of patients with systemic enzyme therapy were
treated by Phlogenzym in the dosage 3 times 3 tablets in the first
three days after operation and subsequently 3 times 2 tablets in the
remaining follow-up period. In the postoperative period the changes
of operated limb volume was monitored. The circumference of a limb
was measured in the area of the largest oedema and 10 cm distally.
Then the volume of this part of limb was calculated as the volume of
conical frustum. The measurements were performed on postoperative
days 1, 3, 5, 7, 10 and 14. The volume value of the 1st day was used
as starting value (100%). The values of subsequent measurements were
then compared to this starting value in both group of patients.
Evaluation of the resorption of traumatic and postoperative
haematoma and analgesis effect of Phlogenzym was also made.
RESULTS: In the group of patients who were administered with
Phlogenzym after operation the reduction of the posttraumatic and
postoperative swelling was continuous and significantly faster in
compared with patients of the control group. A remarkable difference
was revealed by the measurement on 5th postoperative day--in
patients treated by Phlogenzym the starting value of the volume of
the operated in limb was reduced on average by almost 8%. In
contrast, in the control group treated by standard drugs this value
slightly increased above 100%. At the end of the first postoperative
week the monitored volume was on average reduced by 12% in the SET
group compared with1.45% in the control group. At the end of the
follow-up--on 14th postoperative day the volume was reduced in the
SET group by almost 17% compared with 9% in the control group. There
was also an evidently good analgesic effect of the drug. The total
consumption of analgesics of patients in the SET group was
significantly lower, particularly in the early postoperative period.
In the course of the follow-up of both groups no marked differences
were recorded in the changes of the volume of operated limbs in
dependence on the method of fixation applied(intramedullary or
external), sex of the patient or on the affected limb (lower or
upper). The patients tolerated Phlogenzym very well, only one female
patient suffered temporarily from poor digestion which, however, did
not require to interrupt the administration of the drug. No other
undesirable effects occurred.
DISCUSSION: Fixation of long bones belongs to the most frequent
operations intraumatological and orthopaedic departments of all
levels. One of the factors which may have an unfavourable effect on
the final result of fixation is aprolonged post-trauma or
postoperative swelling. The results of the study prove a clearly
positive effect of system enzymotherapy on the reduction of oedema
accompanying the trauma and inflammation. The study proved a
statistical significance of the acceleration of the reduction of
oedema in patients treated by Phlogenzym as compared to the control
group treated by a standard antioedematous drugs.
CONCLUSION: The authors verified that systemic enzyme therapy could
influence significantly the results of traumatological surgery.
Simple administration per os, efficient oedema reduction and thus
accelerated healing, antiophlogistic and analgesic effect--all these
advantages justify the application of this therapeutic method what
can be recommended as a part of the complex treatment in
traumatology with both conservative and surgical approaches.
Key words: system enzymotherapy, antioedematous treatment,
Phlogenzym®.
PMID:
11706714