Widespread interest in parenterally administered proteolytic enzymes in the treatment of trauma is apparent from an examination of the recent literature.1-5 Many enzymes and various routes of administration have been used. Most authors agree that the enzymes are materially beneficial, but their enthusiasm seems to be based on "clinical impressions," clinical observations or subjective improvement. For example, Lichtman6 administered trypsin parenterally to 350 athletes who had sustained bruises, with "excellent" results in 66% of those treated. To either confirm or disprove the reports in the literature, an entirely objective and controlled approach to the problem was essential. Washing machine wringer injuries of the arm in children are common in this area and seemed to present possibilities for a uniformly controlled study, because edema of the arm could be measured accurately, and tenderness could be evaluated objectively.
In this series lyophilized trypsin, in 5% aqueous gelatin solution (Parenzyme Aqueous),*
GLASS TG, FISCHER A. Parenteral Trypsin in Trauma. AMA Am J Dis Child. 1959;97(5_PART_I):571–574. doi:10.1001/archpedi.1959.02070010573006
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