Episiotomy Wound Healing Research Articles

A Review of Episiotomy and Modalities for Relief of Episiotomy Pain.

Episiotomy is a surgically planned incision of the perineum and the posterior vaginal wall in the second stage of labour. It is one of the most commonly performed surgical procedures in the world. In episiotomy, the vaginal orifice is made larger to facilitate the birth of a baby. The postnatal period is very crucial in every mother's life, especially those who had a vaginal delivery and underwent episiotomy. Maternal benefits of episiotomy include reduced risk of perineal trauma, subsequent pelvic floor dysfunction and prolapse, urinary incontinence, faecal incontinence, and sexual dysfunction. Potential benefits for the foetus are thought to include a shortened second stage of labour. However, an episiotomy can also lead to potential adverse consequences, including the extension to a third- or fourth-degree tear, anal sphincter dysfunction, and dyspareunia. Different approaches can be adopted to reduce these complications in the postpartum period, including cleanliness, cold packs, sitz baths, kegel exercises, perineal care, and topical application of dry heat-infrared lamp therapy. Of all these approaches, infrared lamp therapy and sitz baths are the two most effective and commonly used forepisiotomy pain relief and wound healing. In infrared lamp therapy, radiant heat or infrared rays are used to produce heat that is then applied to the episiotomy wound to facilitate pain relief and wound healing, while a sitz bathis a moist heat application process that is also effective for episiotomy pain relief and wound healing. This review aims to offer the most thorough understanding of episiotomy, its current concept, and episiotomy pain relief, with a particular focuson infrared lamp therapy and sitz baths.

“Evaluate the Effectiveness of Perineal Care on Episiotomy Pain and Wound Healing among Postpartum Women”

Introduction: Over 85% of women having a vaginal birth suffers perineal trauma. The rate of episiotomy was determined as 93.3% in primipara women and as 30.2% in multipara women. One of the most important aspects of perineal care is checking for signs of infection. Most women have some degree of discomfort during the first few postpartum days. One of the common causes of discomfort is episiotomy. These include swelling, lesions, rashes, sores and boils. Proper care of perineum after childbirth is very important in order to avoid infection and speed healing of rectal and pelvic muscles. The Objectives are 1. To assess the episiotomy wound healing and pain among post partum women in experimental and control group . 2. To evaluate the effectiveness of perineal care among post partum women 3. To compare the Episiotomy pain and wound healing among post partum women between experimental and control group.4. To determine the association between Episiotomy pain level and wound healing among postpartum women with their demographic variable.Material & Methods: The Quasi Experimental post-test only control group design was adopted. With 60 postpartum women’s were selected by non-probability convenient sampling technique. The prior consent was taken. Tool for data collection for Assessment of Episiotomy wound healing by REEDA scale and Numerical pain rating Scale for Episiotomy Pain.Results: The Results of the study revealed that statistically significant reduction in the level of perineal pain at 6, 24, & 48 hours and three days postpartum between the two groupsA highly statistical significant difference between groups in relation to the interference of pain with walking, sitting, and urination at 24 & 48 hours, and at three days postpartum. Reduction in the REEDA scores of wound healing in experimental group as compared to control group. The current study concluded that, women who received perineal care on episiotomy pain and wound healing during postpartum period have, lower the level of postpartum episiotomy pain scores, decrease pain related to perineal episiotomy which interfere with women’s daily activities postpartum, such as walking, sitting, urination and defecation, and better wound healing progress. On the light of the study findings it is recommended that self perineal pain instruction can be introduced to the women antenatal and then it can be used postnatal, the nursing students should be taught the importance of relieving episiotomy pain and enhancing wound healing in postnatal mothers, and there is a need for extensive and intensive research in this area.

The Effects of Structured Self-Perineal Care Education on Episiotomy Pain Score and Wound Healing Outcome among Primigravida Mothers in Malaysia Urban Area

Background: Pain and wound dehiscence cause physical and emotional traumas, impacting the mothers' quality of life, mental health, and maternal-child bonding. Objectives: The present study aimed to examine the effect of self-perineal care (SPC) education on episiotomy pain scores and wound healing outcomes. Methods: A quasi-experimental design was used in this study. In the third trimester, 125 primigravida mothers attended the antenatal clinic and were assigned to a SPC education group (n=62) and a control group (n=63). The intervention group received two phases of SPC education apart from the study hospital’s routine care, and the mothers in the control group received only routine care. The primigravida mothers in the treatment group were provided SPC education content on their smartphones using the “SPCE” mobile application. Mothers in both groups self-reported their episiotomy pain score and wound healing outcome over 7 days post-childbirth using this mobile application. Results: The overall pain and REEDA scores (redness, oedema, ecchymosis, discharge, approximation) were significantly lower in the intervention group than in the control group for the first 7-days post-delivery with P < 0.001 except for 4 h of baseline observation. For each activity of daily living, the scores were lower in the intervention group for the 7 days post-delivery. Conclusion: Self-perineal care education positively reduced episiotomy pain scores and enhanced wound healing outcomes. This study empowered the primigravida mothers to take responsibility for their health by involving in a self-care education program.

Effect of Rosemary Cream on Episiotomy Wound Healing in Primiparous Women: A Randomized Clinical Trial

BackgroundDelay in episiotomy wound healing can lead to infection. The application of natural antimicrobial agents isolated from herbal essences can be a good strategy to prevent the growth of bacteria and promote the wound healing process. Therefore, this study aimed to determine the effect of rosemary cream on episiotomy wound healing in primiparous women.MethodsThis triple-blind randomized clinical trial was conducted on 80 primiparous pregnant women who were referred to the maternity ward of Shahid Motahari Hospital in Marvdasht, Iran, from September 2019 to March 2020. These women were randomly assigned into two groups of intervention (rosemary cream) and control (placebo), using variable quadruple blocks. Both groups applied the prescribed cream (in a dose of 2 cm) uniformly on the sutured area to cover it with the cream. The cream was applied twice a day for 10 consecutive days postpartum, and the rate of wound healing was evaluated by the researcher in the first 12 h and at days 4 and 10 postpartum using the REEDA scale. The data were analyzed using SPSS software (Version 19) through the Chi-square test, Mann-Whitney U test, student’s t-test, and Fisher’s test. A p-value less than 0.05 (P < 0.05) was considered statistically significant.ResultsThe mean ± SD REEDA score on the fourth day postpartum was obtained at 3.82 ± 0.93 and 4.25 ± 1.29 in the groups of rosemary cream and placebo, respectively (P = 0.17). However, the mean ± SD REEDA scores on the 10th day postpartum were determined at 0.75 ± 0.74 and 3.32 ± 2.54 in the rosemary cream and placebo groups, respectively, indicating a higher rate of episiotomy wound healing in the group of rosemary cream compared to placebo (P < 0.001).ConclusionBased on the obtained results, it seems that rosemary cream can be effective in healing episiotomy wounds in primiparous women. However, further studies are suggested to confirm the findings of this study.Trial registrationThis trial was registered in the Iranian Registry of Clinical Trials in 24/08/2019 with the IRCT ID: IRCT20190308042971N1. The first participant enrolled in this trial in September 2019. URL of registry: https://en.irct.ir/trial/40092.

Evaluate the effectiveness of Infrared Lamp Therapy on Episiotomy wound healing among postnatal mothers at selected hospitals in Kanyakumari District

Background of the study: One of the major problems during postnatal period is episiotomy wound and pain. The lack of episiotomy wound healing leads negative effect on breastfeeding and mother’s baby bonding. Infrared lamp therapy enhances the episiotomy wound healing among postnatal mothers. The aim of the study is to evaluate the effectiveness of infrared lamp therapy on episiotomy wound healing among postnatal mothers. Material and Methods: The design adopted was quasi experimental pre-test and post-test control group design. The purposive sampling technique was used. The selected conceptual framework was Erenestine Wiedenbach’s “The helping art of clinical nursing theory” (1964). The tool used was REEDA scale. Infra red lamp therapy was administered for 15 to 20 minutes twice a day, for three consecutive days. Level of episiotomy wound healing was assessed by the end of third day immediately. Results: The study revealed that in pre-test level of episiotomy wound healing, all the postnatal mothers had no wound healing before administering infrared lamp therapy. After the infrared lamp therapy, it was amazing that the level of episiotomy wound healing was increased in which, 70% of them had good healing and 30% of them had moderate healing. There was a significant difference between pre-test and post-test mean episiotomy wound healing scores (MD=11.46, t=52.52, p&lt;0.001) in experimental group. There was a significant difference in the post-test mean episiotomy wound healing scores (MD=4.70, t=11.03, p&lt;0.001) in experimental and control group. Conclusion: Administration of infrared lamp therapy is an effective non-pharmacological intervention for enhancing episiotomy wound healing among postnatal mothers.

Effectiveness of Video Assisted Teaching Program on knowledge regarding Kegel exercise on Episiotomy pain and wound healing among nursing students of Durg District Chhattisgarh

Introduction: Globally, approximately 140 million births occur every year. In India the incidence of Institutional normal vaginal deliveries 61.5% with 58.4% of normal vaginal delivery with episiotomy. Maternal mortality Worldwide nearly 6 Lakh mothers between the age of 15-49 years die every year due to complication arising from pregnancy and childbirth.Kegel exercises are the most popular method of reinforcing pelvic floor muscles. They were first described in 1948 by the American gynecologist Arnold Kegel. The squeeze and hold vaginal exercises known as Kegel’s were specifically designed to target pelvic floor strengthening which damage due to vaginal delivery. Material and Methods: A Pre-experimental one group Pre-test post-test research design was adopted to conduct the study. Target population was B.Sc. Nursing 3rd year students. A purposive sampling technique was utilized for selecting a sample of 60 B.Sc. Nursing 3rd year students. Section A: - Deals with the socio-demographic variables such as Age, Residence, types of family, period of exposure in Clinical area, Previous knowledge about Kegel exercise and Source of knowledge. Section B: - Deals with self-structured knowledge questionnaire to assess the knowledge regardingKegel exercise on episiotomy pain and wound healing among B.Sc. Nursing 3rd year students. Result: Analysis of pre-test and post-test knowledge score using frequency, percentage and total score indicates that out of 60 B.Sc. Nursing 3rd year students in pre-test majority 3.33% (02) were in good, 63.33% (38) were in averageand 33.33% (20) sample were in need to improve on knowledge regardingKegel exercise on episiotomy pain and wound healingand in post-test majority 76.66% (46) sample were in good, 23.33% (14) were average and 0% (0) were in need to improve.which proves the effectiveness of the video assisted teaching programme.Chi-square analysis shows significant association between knowledge and previous knowledge of subjects, source of information of subjects. Conclusion: A study that conducted the use of video assisted teaching programmeregardingKegel exercise on episiotomy pain and wound healingwas effective in increase knowledge among B.Sc. Nursing 3rd year students.

Evaluation the effect of Silybum marianum ointment on episiotomy wound healing and pain intensity in primiparous women: a randomized triple blind clinical trial

BackgroundEpisiotomy is the most commonn surgical procedure in midwifery which as any other wounds can cause infection or delay in healing.The current study aimed to determine effect of Silybum marianum ointment on pain severity and healing of episiotomy wound in primiparous women referring to Shahid Nourani Hospital at 2019.MethodsThis research was done as a randomized, triple-blind clinical trial on 87 priiparous women (44 indivdiuals in Silybum marianum ointment group and 43 indivdiuals in placebo group) referred to Shahid Nourani Hospital in Talesh (Guilan Province), Iran at September 2019.After labor and performing episiotomy, twice a day for 10 days as a fingertip size of the ointment was prescribed to be topically used on the episiotomy incision for both groups (Silybum marianum ointment or placebo ointment).Data gathering was done using demographic and midwifery information questionnaire, Episiotomy healing assessment: Redness, Edema, Ecchymosis, Discharge, Approximation)REEDA Scale (REEDA Scale: Redness(R); Edema (E), Ecchymosis(E), Discharge from the wound(D); Approximation of the perineal tissues(A))(scale, and visual analogue scale of pain. Examination of healing status of the perinea incision was performed during first 12 h, fifth day and tenth day after labor.Kolmogrov-Smirnov test was used in order to investiagte nomrality of data distribution of quantitative data, and two- independent samples t test, Chi square, repeated measures two factorial analysis of variance and Fischer’s exact test were used. SPSS software version 23 was used to analyze data and 0.05 was considered as signifcance level.ResultsBoth groups of Silybum marianum and placebo groups did not differ regarding demographic and midwifery characteristics, hygiene status prior to intervention (P > 0.05).Mean difference of pain severity and REEDA scale in Silybum marianum ointment group in 12 h after labor, at fifth day and tenth day after labor was significant comparing to control group which indicates decline in episiotomy pain severity and faster wound healing (P < 0.001).ConclusionsSilybum marianum ointment ointment accelerates episiotomy wound healing rate due to its healing properties and decreases pain severity.Trial registrationThis study was registered in Iranian Registry of Clinical Trials in 10/08/2019 with the IRCT ID: IRCT201811100411603N1.

Effectiveness of Olea Herbal Ointment on Episiotomy Wound Healing Among Primiparous Women: A Randomized Clinical Trial

Background: Episiotomy is a surgical incision in the perineal region to increase the vaginal diameter during delivery. Since the perineal region is not well visible to the mothers and there is a possibility of infection for the episiotomy wound by vaginal and rectal bacteria, such a cut is associated with infection and delay in wound healing. Objectives: This study aimed to detect the effect of Olea ointment on episiotomy wound healing among primiparous women. Methods: This randomized controlled clinical trial included 73 women referring to the Al-Zahra Education, Research, and Remedial Center in Rasht, Iran, during 2017 - 18. Women were randomly assigned into two groups: Intervention group (n = 39) and control group (n = 34). Episiotomy wound healing was assessed using the REEDA scale prior to the intervention, 2 and 24 hours following the first intervention, and 5 and 10 days after delivery. Statistical analysis was performed using Fisher’s exact test, Mann-Whitney U test, independent t-test, repeated-measure test, Friedman test, and chi-square. Results: The mean baseline scores of REEDA was 2.72 ± 0.46 in the Olea ointment group and 2.71 ± 0.46 in the control group; however, there was no statistically significant difference between the two groups. On the other hand, the episiotomy healing scores in the Olea ointment group were significantly lower than those of the control group at four intervals in the follow-up assessments: -0.34 (95% CI: -0.56 to -0.12) two hours after intervention, -0.63(95% CI: -0.89 to -0.37) 24 hours after intervention, -0.30 (95% CI: -0.48 to -0.12) on Day 5 postpartum, and -0.29 (95% CI: -0.46 to -0.13) on Day 10 postpartum. Conclusions: The present findings suggested that the Olea ointment facilitated wound healing of episiotomy; however, further studies are suggested to support these data.

A Study to Evaluate the Effectiveness of Sitz Bath on Episiotomy Wound Healing among Postnatal Mothers in Aravindan Hospital at Coimbatore

Statement of the problem: ‘A study to evaluate the effectiveness of sitz bath on episiotomy wound healing among postnatal mothers in Aravindan hospital at Coimbatore. Objectives of the study: 1. To assess the episiotomy wound healing among postnatal mothers both in experimental and control group. 2. To administer Sitz Bath Application to mothers in Experimental Group. 3. To evaluate the effectiveness of sitz bath on episiotomy wound healing among postnatal mothers in experimental group. 4. To compare the effectiveness of sitz bath on episiotomy wound healing among postnatal mothers between experimental and control group. 5. To find out the association between the post observational episiotomy wound healing scores of postnatal with selected demographic variable. Methodology: The quantitative approach - quasi-experimental, non- equivalent control group pre-test. Post-test design was selected to evaluate the effectiveness of sitzbath on Episiotomy wound healing among postnatal mothers The researcher adopted non probability convenient sampling technique and 60 postnatal mothers were selected for the study from Aravindan hospital Coimbatore. They are divided into two groups, 30 in experimental group and 30 in control group. The investigator used Reeda Scale and visual Analog pain scale to assess the episiotomy wound healing. Results: The findings reveal that application of sitz bath is highly effective on severe redness (63.3%), severe oedema (876%), severe ecchymosis (83.3%), severe discharge (93.3%) and poor approximation of wound (90%). Posttest on 5th day revealed that they had moderate redness (30%), moderate oedema (34.3%), mild ecchymosis (27.6%), moderate discharge (38.6%) and improved approximation of wound (27.6%). For all parameters of REEDA calculated t-value &gt;p-value, which infers that application of sitz bath is statistically highly effective for healing of episiotomy at 0.05 level of significance. The calculated t-value is 22 &gt; 2.05, which infers that application of sitz bath is statistically highly effective for healing of episiotomy wound at 0.05 level of significance. The application of sitz bath is highly effective in experimental group based on REEDA parameters as per redness (45%) in experimental group when compared to control group redness (90%), discharge (38.6) in experimental group when compared to control group discharge (53.3%), edema (34%) in experimental group when compared to control group odema. 6%), ecchymoseis 7.6%) in experimental group when compared to control group ecchymosis (53.3%) and on approximation of wound (27.6%) when compared to control group approximation of wound(47.6%). Hence H2 is accepted. Conclusion: This information shows that Application of Sitz Bath is effective in episiotomy wound healing process

The effect of the Verbascum Thapsus on episiotomy wound healing in nulliparous women: a randomized controlled trial

BackgroundThe pain and discomfort caused by episiotomy affect the quality of life of the mothers, so rapid and complete repair of the episiotomy is very important. Due to the effective ingredients of Verbascum Thapsus, it has been used since ancient times to treat wounds. Therefore, this study aimed to evaluate the effect of Verbascum Thapsus on episiotomy wound healing.MethodsThe study was designed as a randomized, double-blind, controlled clinical trial. Ninety-three primiparous women who were referred to Fatemeh Zahra Hospital in Saveh in 2015 were randomly divided into two groups of intervention (Verbascum Thapsus) and control (placebo). Both groups covered the episiotomy wound twice a day for 10 days with 2 cm of prescribed creams. Wound healing was assessed using the REEDA scale before the intervention and on days 1,3 and 10 after the intervention.ResultsBefore the intervention, there was no statistically significant difference in terms of demographic characteristics, obstetrics, and REEDA scores between the two groups (p < 0.05). The mean scores of REEDA on days 1 and 3 in the intervention group were better than the control group but were not statistically significant. However, on the tenth day after the intervention, the mean scores of REEDA were significantly better in the Verbascum group than the placebo (p = 0.01).ConclusionsAccording to the results of this study, it seems that Verbascum Thapsus is effective in repairing episiotomy wounds. The researchers hope that the results of this study can provide clinical evidence for the use of this herbal medicine in the wound healing process.Trial registrationThis study was registered in the Iranian Registry of Clinical Trials (IRCT) with the code “IRCT201404073106N15” on 02/12/2015.

Evaluation of the effect of Teucrium polium ointment on the episiotomy wound healing in primiparous women

Introduction: Episiotomy is a surgical incision at the vaginal opening performed in the second stage of labor during childbirth. The purpose of performing an episiotomy is to increase the size of the soft tissue of the pelvis floor and prevent damage to the perineum, facilitate delivery, and reduce the time during childbirth. Objectives: This study aimed to determine the effect of Teucriumpolium ointment on wound healing in primiparous women. Patients and Methods: This triple-blinded clinical trial was conducted on 84 primiparous women referred to Mahdieh hospital in Tehran. Participants randomly received 2% T. polium ointment and placebo. The first time the ointment was started 24 hours after delivery and continued twice a day for 10 days. Wound healing rate was measured by redness, edema, ecchymosis, discharge, and approximation (REEDA) scale on days 1, 5, and 10 postpartum. The data were analyzed using SPSS version 23. Results: The results were performed on 84 women, 43 people using T. polium ointment and 41 people using placebo ointment. There was no significant difference between the two groups regarding obstetrics and demographic characteristics at the beginning of the study. The mean scores of REEDA in the T. polium group in the first 12 hours, days 5 and 10 were significantly different from the placebo group (P&lt;0.001). Conclusion: Wound healing following episiotomy can be accelerated due to antibacterial, anti-inflammatory, and antiseptic properties of T. polium ointment. Trial Registration: The trial protocol was approved by the Iranian registry of clinical trial (#IRCT20100130003226N18; https://en.irct.ir/trial/40004, ethical code# IR.SBMU.RETECH.1398.055).

Effect of green tea ointment on perineal pain and wound healing after episiotomy: A randomized double-blind clinical trial

IntroductionPerineal pain after an episiotomy is common and distressing and affects quality of life of women who have just given birth. The aim of this study was to determine the effect of green tea ointment on pain and wound healing after episiotomy. MethodsThis randomized controlled trial was conducted in 2019 on 130 parturient mothers in Hamadan, Iran. Mothers were assigned into two groups using blocked randomization. Data collection tools were a demographic questionnaire, Redness, Edema, Ecchymosis, Discharge, and Approximation (REEDA) scale to measure episiotomy wound healing, and a Visual Analogue Scale (VAS) to measure episiotomy pain score. REEDA and VAS were completed 6 h after episiotomy surgery. Green tea ointment was administered to the patients in the intervention group twice a day for 10 days while the control group received placebo. On days 5 and 10 following the intervention, REEDA and VAS were completed. The data were analyzed using Stata-13 software and the significance level was considered at p <0.05. ResultsComparison of the wound healing scores between the two groups on days 5 and 10 indicated no statistically significant differences. There was a significant difference between the two groups in terms of episiotomy pain score on days 5 and 10 and Cohen's d revealed the effect of the intervention on episiotomy pain (0.64 and 0.68, respectively, p-value=0.001). ConclusionThe results of the study suggested that green tea ointment appeared to improve episiotomy pain but did not significantly change wound healing.

Effect of chlorhexidine gluconate solution on healing process in care of episiotomy wound

Purpose: Determination of the effect of chlorhexidine gluconate (CG) solution (containing 70% alcohol) on the process of episiotomy wound healing. Materials and Methods: This is a semi-experimentally designed study with pre-test post-test control group. In the research, after the episiotomy intervention 45 puerperal, those were treated with routine hospital care formed the control group, the other 45 puerperal who were treated with Serum Physiological (SP) solution formed the 1st group and the remaining 45 puerperal who were treated with CG solution formed the 2nd treatment group. Results: When the REEDA scale of the puerperals are evaluated; The wound care with the CG solution was more effective in terms of reduction of the redness, edema, ecchymosis, and drainage in the episiotomy area and in the closure of the wound edges. Statistically lower levels of pain complaints were found in the patients who used CG solution in episiotomy treatment compared to those who received routine care and SP solution. In episiotomy treatment, the CG solution appeared to be an effective and promoting product for wound healing.Conclusion: We concluded that CG solution is an effective wound care product, which contributes to wound healing in patients with episiotomy.

Episiotomy wound healing by Commiphora myrrha (Nees) Engl. and Boswellia carteri Birdw. in primiparous women: A randomized controlled trial

Ethnopharmacological relevanceTraditional Persian medicine manuscripts refer to plants such as Commiphora myrrha (Nees) Engl. (myrrh) and Boswellia carteri Birdw. (frankincense), which could be used to improve wound healing process. Since that time, local midwives in Iran continue to provide these herbs to precipitate episiotomy wound healing. Aim of the studyTo investigate the efficacy and safety of myrrh- and frankincense-based sitz-baths on episiotomy wound healing in primiparous women. Materials and MethodsThis randomized controlled trial was conducted on 90 primiparous women with singleton pregnancies after normal vaginal delivery at Hafez hospital affiliated to Shiraz University of Medical Sciences from July to October 2019. Study participants were randomly allocated in three groups (2 intervention groups and 1 control group). Women in intervention groups were assigned to receive either 10-min sitz-bath of myrrh extract or frankincense extract twice a day for 1 week. While the women in control group received the betadine sitz-bath for the same period of time. The main outcome was the episiotomy wound healing, which was measured using the REEDA scale before intervention, on 2nd and 7th postpartum days. ResultsAn improvement in the episiotomy wound healing was significantly greater in patients receiving myrrh than those receiving the frankincense or betadine on 2nd (p = 0.003 and p < 0.001) and 7th (p = 0.043 and p = 0.015) postpartum days. However, the total REEDA score was not statistically different between the frankincense and betadine groups on 2nd and 7th postpartum days (p > 0.05). ConclusionThe present results suggest that myrrh was more efficient than frankincense and betadine in healing of the episiotomy wound and could be recommended as a safe natural therapy.

The Effect of Olive Oil and Honey Combination on Episiotomy Wound Healing and Pain Relief: A Randomized Clinical Trial

Background: Episiotomy is one of the most common surgical procedures in the world that is associated with perineal pain and can be exposed to infection, or might be healed with delay. Objective: The aim of this study was to investigate the effects of honey-olive oil combination on episiotomy wound healing and pain relief in primiparous women. Methods: This single-blind, parallel randomized clinical trial (IRCT20120215009014N208) was conducted on 80 primiparous women. They were allocated randomly to each of the groups through random allocation rule: 40 in honey-olive oil group and 40 in the control group. Every 12 hours and for 14 days, the treatment group used about 1 inch of the cream on the wound area. Pain intensity and wound healing were measured by REEDA Scale and Visual Analogue Scale on days 7, 10, and 14 in both groups. The statistical analyst was not informed about the allocation of the groups. A significant level of 0.05 was considered. Results: There was a significant difference between healing score and pain intensity between the two groups on 7th, 10th and 14th postpartum days (p &lt;0.05). Wound healing occurred much faster (Scores on days 7,10, and 14 were 11.25±2.13, 7.47±1.96 and 4.95±1.53 in the control group and 4.45±1.25, 2.32±.69 and 10±.30 in the intervention group, p &lt;0.05). Moreover, pain intensity was significantly relieved in those who used Honey and olive oil cream (the scores were 5.6750±1.43, 3.3500±1.52, 2.2250±1.34 in the control group and 1.9750±1.52, .2250±.57, .0250±.15 in the intervention group, p&lt;0.05). Conclusion: Using honey and olive oil combination improves episiotomy wound healing and also relieves its’ associated pain.

Effect of Lavender on Episiotomy Wound Healing and Pain Relief: A Systematic Review

Background: Perineal pain is the most common post-episiotomy complication, and delay in episiotomy wound healing can lead to infection. Linalool and linalyl acetate are the most effective compounds of lavender. The present systematic review was performed on the effect of lavender on episiotomy wound healing and pain relief. Aim: Systematic review of clinical trials to determine the effect of lavender on episiotomy wound healing and pain relief Method: In the present study, the research question was determined based on PICO, and search process to screen the related articles was conducted on electronic databases of SID, Iran Medex, Pubmed, EMBASE, Scopus, Science Direct, and Google Scholar using English keywords and Persian equivalents of Episiotomy, healing, Pain, Lavender, and Complementary Medicine from inception until March 2020. Inclusion criteria entailed randomized human clinical trials published in Persian and English on the effect of lavender on episiotomy wound healing and pain relief with a Jadad score of 3≥. Irrelevant, duplicate, descriptive, or qualitative studies were excluded. Cochrane risk-of-bias tool was used for the quality assessment of included articles. Results: Out of 143 articles found in the primary search, five clinical trials were systematically reviewed. All five studies examined the effect of lavender essential oil on episiotomy pain relief, while the effect of lavender essential oil on episiotomy wound healing was measured only in three studies. Implications for Practice: Lavender essential oil (sitz bath twice daily) can be suggested as the treatment of choice in episiotomy wound healing and pain relief. Further studies are suggested to obtain stronger scientific evidence on the effective dose, complications, and the feasibility of meta-analysis.

Healing effect of Quercus persica and Lawsonia inermis ointment on episiotomy wounds in primiparous women

Background:Episiotomy is one of the most common surgical interventions performed to facilitate delivery. Anti-inflammatory and antibacterial effects of Persian oak (Quercus persica) and henna (Lawsonia inermis) have been proved in previous studies. The aim of this study is to evaluate the effect of Q. persica and L. inermis ointment on episiotomy wound healing in primiparous women and comparing it with placebo group.Materials and Methods:This was a double-blind clinical trial conducted on 160 primiparous women who underwent episiotomy. The cases were randomly selected and divided into four groups of forty patients including control, placebo, those who consume topical henna, and those who consume topical Persian oak ointment. Pain and recovery assessment was done at baseline and 7th, 10th, and 14th days after birth and measured by Redness, Edema, Ecchymosis, Discharge, and Approximation (REEDA scale) and patients’ pain intensity was also measured by a visual analog scale (VAS). The collected data were analyzed using Chi-square test, one-way ANOVA, and repeated measures ANOVA test by SPSS (version 22).Results:The results revealed that according to the reduced score of REEDA till the 14th day after the delivery, the wound healing in the henna group and the oak group (−2.58 ± 0.29 and − 2.04 ± 0.31, respectively) was higher than the control and placebo groups (−1.62 ± 0.34 and − 1.95 ± 0.32, respectively) (P < 0.05). Furthermore, on the 14th day, the mean VAS score was not significantly different between henna and oak groups (henna group: 2.58 ± 0.25 and oak group: 2.23 ± 0.18); however, both intervention groups had a significant difference with the placebo and control groups (P < 0.05).Conclusion:The findings showed that the use of henna and oak ointment improves episiotomy wound healing process, so it is recommended for primiparous women.

Effect of Aloe Vera Gel versus Normal Saline on Pain Relief and Healing Process of Episiotomy

Introduction: Spontaneous or episiotomy-induced damage to the genital organs during delivery affects the quality of active labor, especially among primiparous women. It is frequently observed during delivery and can have detrimental effects on a mother’s health and quality of life. Aim of the study to determine the effect of Aloe Vera gel versus normal saline on pain relieve and healing process of episiotomy. Materials and method: Design : A comparative quasi-experimental research design was utilized. Subjects: A convenience study subject of (120) women were selected from EL-Shatby Maternity University Hospital. Tools: Four tools were used by the researchers to collect the necessary data: Tool I: basic data structured interview schedule, Tool II: Pain Intensity Visual Analogue Scale (VAS), Tool III: Wound Healing REEDA Scale and Tool IV: Bacteriological Wound Study. Results : There was a statistically significant differences between both groups in relation to perineal pain intensity after 10 postnatal days (X 2 = 7.937, p = 0.005). On the 10 th postpartum day, the entire Aloe Vera group did achieve complete healing of episiotomy wound compared to 80% of the normal saline group. There was a statistically significant difference between both groups (p &lt; 0.0001). Conclusion : it could be concluded that the application of Aloe Vera gel was more effective on wound healing and perineal pain than normal saline among postnatal women with episiotomy. Moreover the growth of the isolated organisms among the episiotomy wound treated with the Aloe Vera gel were less than among those treated with normal saline. Keywords: postpartum, episiotomy, Aloe Vera Gel and normal Saline DOI : 10.7176/JHMN/70-09 Publication date: January 31 st 2020

The Effect of Sitz Bath of Hydro-Alcoholic Extract of Myrrh Gum on Episiotomy Wound Healing in Nulliparous Women

Objective: To investigate the effect of sitz bath of hydro-alcohol extract of myrrh plant on episiotomy wound healing. Materials and methods: the clinical trial was performed on 60 nulliparous women from July 2017 to December 2017. After episiotomy, the intervention and control groups respectively underwent sitz bath of myrrh gum and normal saline for 7 days. Data collection was REEDA scale. Results: Significant difference between the mean score of redness, proximity of wound edges to each other and REEDA scale in both groups on the third, seventh and tenth days after delivery (p < 0.05). There was a significant difference between mean scores of bruise on the 10th day and wound discharge on the 7th and 10th days. The mean scores of bruise were not significantly different between the two groups (p > 0.05). Conclusion: The effect of this myrrh plant on episiotomy wound healing is greater and faster than the effect of usual cares.

The effect of Myrtus communis cream on wound healing and severity of episiotomy pain: Double-blind clinical trial

Introduction: Episiotomy is of common surgical procedures in midwifery and is followed by complications including inflammation, edema, approximation of the wound and perineal pain. In past, Myrtus communis plant has been used to treat wounds and relieve pain. This study was performed with aim to investigate the effect of M. communis cream on wound healing and episiotomy pain severity. Methods: This double-blind clinical trial was conducted on 100 nulliparous women in Zabol Amiralmomenin Ali Hospital from July to November 2018. The participants randomly received Myrtus Communis cream or placebo and used the encoded creams 2 times a day for 10 days. Demographic and obstetrics questionnaire, health status form, analgesic used, Numeric pain rating scale, Reeda scale and drug side effects table were used to assess the individuals. Then, the pain severity and recovery rate were examined on the first 2 hours, fifth and tenth day after delivery. Data were analyzed by SPSS software (version 23) and Mann-Whitney, independent-t, and Chi-square tests. P 0.05). The mean difference of pain severity on the fifth (p=0.009) and tenth day (p=0.012) after delivery was significant in M. communis cream and placebo cream groups, and the severity of pain was less pain in M. communis cream group. The mean of Reeda score group on the 5th day after delivery was 1.70 ± 1.09 in the M. communis cream group and 2.94 ± 1.51 in the placebo cream group (p<0.001), and on the tenth day after delivery was 1.04 ± 0.854 in the M. communis cream group and 2.06 ± 0.620 in the placebo cream group that was statistically significant (p<0.001). Conclusion: M. communis cream due to its healing properties accelerates the healing of episiotomy wound and reduces the severity of pain.