One single drug combination of bromelain and Boswellia serrata casperome®: effects on postoperative Edema in open incisional abdominal hernia repair. Prospective randomized clinical trial

Introduction: Aim of this study is to investigate the significant postoperative benefits on patients about edema of tissues after incisional hernia repair with synthetic mesh using a combination of Bromelain (200 mg) and Boswellia Serrata Casperome® (200 mg), evaluated by ultrasound (US), and compared to control patients group (not treated with drugs). Material and method: From May 2018 to May 2019, fifty adult patients submitted to onlay incisional hernia repair using synthetic mesh with component separation of the abdominal wall and were divided into two homogenous groups (27 females, 23 males, mean age 61 years, mean BMI 32). Only the treated group took one tablet of drug for 30 days on an empty stomach, starting from the first post-surgery day. Checks were made on all patients from the first post-surgery day and going on 15th, 30th and 60th post-surgery days by US linear probe measuring edema, defining its thickness and average diameter. Results: The two groups were homogeneous compared to the initial diameter of the abdominal wall defect (p=0.877). Therefore, the edema thickness was independent of the size of the starting defect in the two groups examined. The edema was already reduced in the treated group compared to the control group at 15 post-surgery days; therefore this reduction became statistically significant starting from US result at 30 post-surgery days of drug treatment (p=0.043) and was even greater in the US result after 60 post-surgery days (p=0.001). Conclusion: Results obtained in this preliminary study showed a rapid and significant improvement in postoperative edema outcome of incisional hernia repair in patients treated with drug. Benefits of treatment are also found in patients even after one month of drug suspension.