title: Therapeutic uses of pineapple-extracted bromelain in surgical care - A review.
abstract: Bromelain is an extract obtained from the pineapple plant and is used as a traditional folk remedy for several ailments. In this review, a comprehensive electronic database search was carried out to compile available literature on therapeutic implications of bromelain. Pharmaceutical value of bromelain has been demonstrated in different surgical sub-specialties. Diverse biological processes like anti-inflammatory, anti-oedematous, analgesic, anti-thrombotic, exfoliation etc. are involved in bromelain's therapeutic actions, mediated through the kallikrein-kinin and arachidonic acid pathways as well as through effects on cell mediated immunity. Bromelain equals non-steroidal anti-inflammatory drugs as an anti-inflammatory agent, but has been shown to have fewer side effects. In Europe it is approved for oral and topical use, mainly for surgical wounds, inflammation due to trauma and surgery, and debridement of deep burns. Literature suggests a promising role of bromelain in surgical care. More clinical trials to establish its utility as an anti-inflammatory agent in surgical care are recommended.
authors.affiliation: Section of Orthopaedics, Department of Surgery, Aga Khan University, Karachi, Pakistan.
authors.forename: Zehra Abdul
authors.initials: ZA
authors.lastname: Muhammad
authors.affiliation: Section of Orthopaedics, Department of Surgery, Aga Khan University, Karachi, Pakistan.
authors.forename: Tashfeen
authors.initials: T
authors.lastname: Ahmad
mesh_terms: D031230:Ananas / Q000201:enzymology*; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal; D001963:Bromelains / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use; D002056:Burns / Q000188:drug therapy; D002478:Cells, Cultured; D003646:Debridement / Q000379:methods*; D006801:Humans; D014945:Wound Healing / Q000187:drug effects; D014947:Wounds and Injuries / Q000188:drug therapy
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001963:Bromelains
keywords: Bromelain, Pineapple, Wound healing, Inflammation, Anti-inflammatory, debridement.