The Effectiveness of Bromelain on Oedema, Subconjunctival Haemorrhage, and Ecchymosis After Rhinoplasty: A Randomised, Double-Blind, Placebo-Controlled Trial.

2025-02-04
Aesthetic plastic surgery 49(13)
- Benyamin Rahmaty
- Mohsen Naraghi
- Alireza Mesbahi
- Alireza Mohebbi
- Bahman Sadeghi
- Amir Reza Zadeh
- Amir Almasi

PubMed: 39904804
DOI: 10.1007/s00266-024-04646-2

Study Design

Type: Randomized Controlled Trial (RCT)
Population: participants aged 18-45 who were scheduled for open preservation rhinoplasty using the push-down technique and lateral osteotomy
Methods: Randomised, double-blind, placebo-controlled trial; 23 cases assigned to placebo group and 23 to experimental group Bromelain
Blinding: Double-blind

Objective

To evaluate the effectiveness of bromelain on periorbital oedema, subconjunctival haemorrhage, and ecchymosis after preservation rhinoplasty.

Study design

Randomised, double-blind, placebo-controlled trial SETTING: Tertiary referral centre METHODS: In this double-blind clinical trial, participants aged 18-45 who were scheduled for open preservation rhinoplasty using the push-down technique and lateral osteotomy were recruited. Twenty-three cases were assigned to the placebo group and twenty-three to the experimental group Bromelain.

Results

Regarding gender, 17.39% (8 cases) were male, and 82.61% (38 cases) were female. Comparing the severity of left and right eye ecchymosis between groups at different times showed that bromelain was significantly effective on both sides on the 7th day (p = 0.012). Like ecchymosis, the results demonstrated that bromelain was also considerably effective on subconjunctival haemorrhage on the seventh day post-operatively (p = 0.015). However, the intensity of oedema between groups at different times did not significantly differ.

Conclusion

Bromelain increases serum fibrinolytic activity and decreases plasma fibrinogen levels. It is significantly more effective on subconjunctival haemorrhage and ecchymosis compared with the placebo on the seventh day in both eyes after rhinoplasty. Hence, this study indicates that bromelain is remarkably more effective than a placebo in reducing subconjunctival haemorrhage and ecchymosis.

Trial registration

Iranian Registry of Clinical Trials ID: IRCT20180519039720N2 LEVEL OF EVIDENCE I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Research Insights

Bromelain→Reduced Ecchymosis
Comparing the severity of left and right eye ecchymosis between groups at different times showed that bromelain was significantly effective on both sides on the 7th day (p = 0.012).
Effect
Beneficial
Effect size
Moderate
Bromelain→Reduced Edema
However, the intensity of oedema between groups at different times did not significantly differ.
Effect
Neutral
Effect size
Small
Bromelain→Reduced Subconjunctival Hemorrhage
Like ecchymosis, the results demonstrated that bromelain was also considerably effective on subconjunctival haemorrhage on the seventh day post-operatively (p = 0.015).
Effect
Beneficial
Effect size
Moderate