Abstract
Puerperium is a period when the mother experiences intense physical and emotional stress due to exhaustion, anxiety and excitement. Each mother has to adjust to physical changes in her own body due to involution and lactation as well as cope up with the new demands on her time and emotions made by the new born baby. Episiotomy, despite evidences that it is an unnecessary intervention, is one of the most common surgical procedures performed during the second stage of labour, especially in primigravida woman. Thus, a randomized controlled trial to assess the effectiveness of topical application of chlorhexidine and prevailing practices on episiotomy wound among postnatal mothers at selected hospital of Indore was undertaken. True experimental approach with pre test post test research design was adopted. Simple random sampling was taken to select 40 postnatal mothers with episiotomy wound and three days postpartum hospital stay in Choithram Hospital & Research Centre, Indore as per the inclusion criteria. Data was collected with help of questionnaire for socio demographic data and obstetrical data and the wound healing was assessed by REEDA wound healing assessment scale. Samples in the experimental group were applied with chlorhexidine on episiotomy wound and the samples in the control group received routine care with betadine or nadoxin. Post assessment score was taken on third day (evening) by REEDA wound assessment scale. Finding of the study related to effectiveness of chlorhexidine among postnatal mothers in experimental group revealed that there was a significant difference in the healing of episiotomy wound by the application of chlorhexidine among postnatal mothers in experimental group at t19 = 11.40 at the level of p< 0.001. Hence it was inferred that topical application of chlorhexidine on episiotomy wound promotes wound healing.
Highlights
When the extraordinary changes in physiology that occur throughout pregnancy is considered, it should come as no surprise that the period of physiological adjustment and recovery following the end of pregnancy is both complex and closely related to the overall health status of the individual
Data presented in table no. 2 shows that the computed t value 2.10 at df 37 with S.D. 0.95 indicates that there was a significant difference in post test healing level at the level p < 0.05 which shows there was a significant difference of healing of episiotomy wound on third day among postnatal mothers in control group and experimental group
Data presented in table 3 shows that the computed t value 18.76 at df 18 with S.D. 0.88 indicates that there was a significant difference in post test healing level of the postnatal mothers at the level p < 0.05 which shows there was a significant difference in the healing of episiotomy wound by the application of chlorhexidine among postnatal mothers in experimental group
Summary
When the extraordinary changes in physiology that occur throughout pregnancy is considered, it should come as no surprise that the period of physiological adjustment and recovery following the end of pregnancy is both complex and closely related to the overall health status of the individual. Parity, and use of epidural anesthesia appear to play a role in the decision to perform episiotomy. An upright or lateral maternal childbirth position is associated with fewer episiotomies than the supine or lithotomy positions, while epidural anesthesia and primiparity may increase the incidence. Instruct mother to wear perineal pads loosely and to lie in Sim's position (sidelying position). Episiotomy suture is cleaned with antiseptic solution and observed for any redness, edema, ecchymosis; discharge and approximation of wound etc. Episiotomies are performed on over 90% of first-time mothers delivering in major United States Hospitals. The researcher selected “An experimental study to assess the effectiveness of topical application of chlorhexidine and prevailing practices on episiotomy wound among postnatal mothers at selected hospital of Indore in the year 2012-2013”
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