Episiotomy Wound Research Articles

Comparative Study on the Effects of Myrtle and Chamomile Essential Oils on Pain and Episiotomy Wound Healing in Primiparous Women: A Randomised Controlled Clinical

Comparative Study on the Effects of Myrtle and Chamomile Essential Oils on Pain and Episiotomy Wound Healing in Primiparous Women: A Randomised Controlled Clinical

A prospective observational study on feto-maternal risk factors for different degree of perineal tear among the mothers delivered vaginally with episiotomy wound

A prospective observational study on feto-maternal risk factors for different degree of perineal tear among the mothers delivered vaginally with episiotomy wound

Healing Advantages of β-Sitosterol Cream in Comparison with Lavender Essential Oil in Episiotomy Wounds

The pain intensity during the baseline visit among Lavender group were mild 3 (10%) , moderate 16 (53.3%), and sever 11 (36.7%), in comparison to β-sitosterol 1(3.3%), 16 (53.3%), and 13(43.3%) respectively , among control group were 3(3.3%), 15(50 %) and 14(46.7%) respectively. The pain intensity during day 7 visit among Lavender group were no pain 12(40%), mild 18(60%), and moderate 0(0%), in comparison to β-sitosterol 6 (20%), 19(63.3%), and 5(16.7%) respectively, among control group were 6(20%), 6(60%) and 18(60%) respectively, this difference was statistically significant. The pain intensity during day 14 visit among Lavender group were no pain 30(100%), and mild 0(0%), in comparison to β-sitosterol 26 (86.7%), and 4(13.3%), respectively. Regarding redness; was no redness among 16 (53.3%), 14(46.7%) mild redness, and moderate redness 0(0%) of the Lavender group in comparison to 10(33.3%), mild 18(60%), and moderate 2 (6.7%) among β-sitosterol group, and 2(6.7%), 20(66.7%) and 8(26.7%) among control group respectively, this relation were statically significant. Regarding edema; was no edema 21(70%), and mild edema 9(30%) among Lavender group in comparison to 12 (40%), mild 16(53.3%) among β-sitosterol group, and 6(20%), and 16(53.3%) among control group, this relation were statically significant. Discharge was none 10(33.3%), and 16(53.3%) among Lavender group in comparison to 4(13.3%), mild 24(80%) among β-sitosterol group, and 4(13.3%), and 12(40%) among control group, this relation were statically significant P value < 0.05. Approximation was (good) closed wound sites among 14(46.7%), and mild approximation among 13(43.3%) of Lavender group in comparison to good 6(20%), mild 22 (73.3%) among β-sitosterol group, and 6(20%), and 18(60%) among control group. Lavender can be used as a suitable therapy for postpartum episiotomy wound care. There is no side effect found among the patients. β-sitosterol is also good in the treatment of the postpartum episiotomy wound but had lower effect than Lavender with higher price. Keyword: β-sitosterol versus Lavender in Episiotomy, β-sitosterol in Episiotomy, Lavender Essential Oil in Episiotomy Corresponding author: Rawaa Khalid Khalaf (rawaakalid7@gmail.com)

Relationship between Male Sexual Dysfunction, Fertility Power and Heart Function: Avicenna’s Standpoint

Honey has been used since ancient times to treat various diseases such as gynecological diseases. The current study aims to investigate clinical trials related to the therapeutic effects of honey on women’s diseases. Databases including Web of Sci- ence, Scopus, PubMed, Google scholar, and SID were investigated for clinical studies focusing on honey in gynecological diseases up to 31 June 2022. Eligibility was checked based on selection criteria. Twenty-five clinical trials met the inclusion criteria. Therapeutic properties of honey and its compounds as a systemic and/or local treatment on vulvovaginal candidiasis, cervicitis, dysmenorrhea, premenstrual syndrome, labor pain, episiotomy and cesarean wounds, nipple fissure, breast cancer and intrauterine insemination (IUI), with the mechanisms of action of antibacterial, antifungal, anti-inflammatory, wound healing, analgesic, antioxidant and anticancer activities have been proven. It was also found that phenolic compounds includ- ing flavonoids and phenolic acids are the main ones responsible for most of these therapeutic effects of honey. This study supports the healing properties of honey in gynecological diseases at reproductive age. Also, in the current studies, honey proved safe with minor adverse effects. Of course, to achieve definitive conclusions about the effectiveness and safety of honey, it is necessary to conduct more clinical trials with a larger sample size, appropriate intervention duration, and optimal doses in future studies.

Comparative Efficacy of Aloe Vera Gel versus Normal Saline in Accelerating Episiotomy Wound Healing: A Randomized Controlled Trial

Background: Episiotomy is a common obstetric procedure designed to aid vaginal delivery but often complicates postpartum recovery due to wound-related issues. Traditionally, these wounds are treated with normal saline. Recent studies suggest that aloe vera gel may enhance wound healing more effectively, yet comprehensive local data is lacking. Objective: To compare the efficacy of aloe vera gel with normal saline in promoting episiotomy wound healing by the 10th postoperative day. Methods: This randomized controlled trial included 60 gravid females undergoing normal vaginal delivery with episiotomy, randomly allocated into two groups: one treated with aloe vera gel and the other with normal saline. The primary outcome was wound healing, assessed on the 10th postpartum day using the REEDA score, categorized as complete (score <5), partial (score 5-9), or no healing (score 10-15). Written informed consent was obtained from all participants. Results: Participants had an average age of 27.6 ± 5.2 years. The mean REEDA score on the 10th day postpartum was significantly lower in the aloe vera gel group (1.97 ± 1.22) compared to the normal saline group (3.57 ± 2.05; p = 0.001). The frequency of complete wound healing was 100% in the aloe vera group versus 76.7% in the saline group (p = 0.011). Conclusion: Aloe vera gel significantly outperformed normal saline in healing episiotomy wounds by the 10th postoperative day, suggesting its advantageous use over traditional saline dressings in obstetric practice.

Randomized controlled trial of the effectiveness of olive and black seed oil combination on pain intensity and episiotomy wound healing in primiparous women: A study protocol.

Episiotomy is associated with side effects, such as pain and wound infection. Additionally, discomfort after episiotomy affects the quality of life of both the mother and the baby. Medicinal herbs are one alternative method for the treatment of episiotomy wounds. This study will investigate the effectiveness of the combination of olive and black seed oil on pain intensity and the healing of episiotomy wounds in primiparous women. This randomized clinical trial will be conducted on primiparous women who have had a normal delivery with an episiotomy. There are 3 groups in this study: one group will receive a combination of olive oil and black seed oil, another group will receive olive oil alone, and the use of oils will start 24 hours after delivery. Ten drops will be applied topically 3 times a day for 10 days. The third group (control) will receive only routine care. Data will be collected through a demographic characteristics questionnaire, REEDA (Redness, Edema, Ecchymosis, Discharge, and Approximation) Scale, and Visual Analog Scale. To determine and compare the effects of pharmaceutical interventions on pain intensity and episiotomy wound healing in the groups, an analysis of variance (ANOVA) test with repeated measurements will be used with SPSS version 22. The results of this study will show the effects of a combination of olive and black seed oil, as well as olive oil alone, on pain intensity and episiotomy wound healing in primiparous women. The positive effects observed in this trial with these oils could be valuable for women who have undergone an episiotomy.

CASE SERIES ON EFFICACY OF VAPU SPRAY IN EPISIOTOMY WOUND

BACKGROUND: A surgically planned incision on the perineum and the posterior vaginal wall during the second stage of labour is called episiotomy (perineotomy). In Ayurveda Samhita, the description of an episiotomy wound has not been given directly, but Vrana(wound) is described very well, and an episiotomy wound can be considered Yoni Vrana. In the present era, there are several methods for managing episiotomy wounds, such as NSAIDs, antibiotics, etc. Still, it is found to have various adverse effects like inflammation, itching, peptic ulcer, delayed wound healing and drug resistance. Hence, the prime focus is proper care and treatment to promote episiotomy wound healing and avoid complications. AIM- To evaluate the preventive and therapeutic efficacy of VAPU Spray on perineal wound healing after episiotomy. OBJECTIVE- To analyse the effect of VAPU spray in managing episiotomy wounds. MATERIALS AND METHODS- The study was conducted among a few postnatal patients with Right mediolateral episiotomy (RMLE), and four such subject evaluations are presented here. RESULTS: These patients were successfully treated with VAPU Spray, which contains Panchavalkala, Triphala, etc., and has Vrana Shodhana and Vrana Ropana qualities. The result was assessed by using the REEDA Scale and VAS scale. The considerable results were pain, oedema, discharge, redness, and tenderness in episiotomy wounds. CONCLUSION- Thus, we can conclude from the study that this Ayurveda regimen with a modified drug delivery system was influential in managing episiotomy wounds

Prediction of the healing efficiency of episiotomy wounds using hydrogel dressings with lidocaine

The objective: to study the factors affecting the healing process of an episiotomy wound and the effectiveness of using hydrogel dressings with lidocaine for its healing.Materials and methods. The prospective randomized study includes the analysis of anamnestic data from the medical cards of 123 primiparous women with episiotomy wounds who gave birth in the Kyiv City Maternity Hospital No. 5 during 2021–2022. The women were divided into two groups: a comparison group – 63 patients who received standard treatment, and a research group – 60 patients who additionally used hydrogel dressings with lidocaine on the wound.The healing of episiotomy wounds was evaluated according to the REEDA scale. Factors that may influence episiotomy wound healing were studied in patients of both groups: anthropometric indicators (age, height, body mass index), interventions during childbirth, and indicators of obstetric and gynecological history (term of gestation, volume of blood loss during childbirth, body weight of the newborn, etc.). Statistical analysis was performed using the Fisher, Mann–Whitney, Student and chi-square tests of the statistical package EZR v. 1.54.Results. Age (p=0.689) and body mass index (p=0.974) of patients in both groups did not show statistically significant differences. The duration of the second period of labor on average was 72 min (57.6–86.4) in the comparison group versus 43.2 min (28.8–57.6) in the research group with a statistically significant difference (p<0.001). No statistically significant differences were found between the two groups regarding the term of delivery, the volume of blood loss, the weight of the newborn, the risk of pregnancy loss, the frequency of labor induction, the weakness of labor activity, manual revision of the uterine cavity, and vacuum extraction of the fetus. The frequency of use of different types of anesthesia during childbirth also did not differ (p=0.396).REEDA scale assessment revealed a reduced risk of high sum scores in the research group (odds ratio (OR) = 0.16, 95% confidence interval (CI): 0.07–0.38), that supports the efficacy of hydrogel dressings with lidocaine. Analysis of the duration of the second labor period and gestational term also revealed an association with the risk of a high sum of points on the REEDA scale (OR = 1.22, 95% CI: 1.02–1.45 per 0.01 days; OR = 1.65, 95% CI: 1.16–2.35 per week of pregnancy).A multivariate model which included research group, body mass index, duration of the second labor period, gestational term confirmed a reduced risk according to the REEDA scale in this group (OR = 0.19, 95% CI: 0.08–0.47). The four-factor model had a high accuracy (AUC = 0.81, 95% CI: 0.73–0.88), indicating a strong relationship between the selected factors and the risk of complications after episiotomy.Conclusions. The use of hydrogel dressings with lidocaine and taking into account some aspects of childbirth, namely, the duration of childbirth and gestational period, can contribute to the improvement of the course of healing of episiotomy wounds. Such a comprehensive approach supports the effectiveness and significance of using hydrogel dressings with lidocaine in the practice of modern obstetrics to improve the results of treatment of patients with an episiotomy wound.In the future, studies on the effectiveness of using hydrogel dressings for the treatment of episiotomy wounds are necessary.

Comparative evaluation of efficacy of infrared radiation to routine care on episiotomy wound healing among postnatal women

Comparative evaluation of efficacy of infrared radiation to routine care on episiotomy wound healing among postnatal women

The Role of Honey in Reproductive Age Gynecological Diseases: An Overview of Clinical Trials

Honey has been used since ancient times to treat various diseases such as gynecological diseases. The current study aims to investigate clinical trials related to the therapeutic effects of honey on women's diseases. Databases including Web of Science, Scopus, PubMed, Google scholar, and SID were investigated for clinical studies focusing on honey in gynecological diseases up to 31 June 2022. Eligibility was checked based on selection criteria. Twenty-five clinical trials met the inclusion criteria. Therapeutic properties of honey and its compounds as a systemic and/or local treatment on vulvovaginal candidiasis, cervicitis, dysmenorrhea, premenstrual syndrome, labor pain, episiotomy and cesarean wounds, nipple fissure, breast cancer and intrauterine insemination (IUI), with the mechanisms of action of antibacterial, antifungal, anti-inflammatory, wound healing, analgesic, antioxidant and anticancer activities have been proven. It was also found that phenolic compounds including flavonoids and phenolic acids are the main ones responsible for most of these therapeutic effects of honey. This study supports the healing properties of honey in gynecological diseases at reproductive age. Also, in the current studies, honey proved safe with minor adverse effects. Of course, to achieve definitive conclusions about the effectiveness and safety of honey, it is necessary to conduct more clinical trials with a larger sample size, appropriate intervention duration, and optimal doses in future studies.

To Assess the Effectiveness of Lavender Oil on Episiotomy Wound among Postnatal Mothers Admitted in Selected Maternity Hospitals

A quasi-experimental study to assess the effectiveness of lavender oil on episiotomy wound among postnatal mothers admitted in selected maternity hospitals. Objectives: 1. To assess the episiotomy wound among postnatal mothers in control and experimental group. 2. To assess the effectiveness of lavender oil on episiotomy wound in experimental group. Review of literature: 1. Studies related to episiotomy. 2. Studies related to effectiveness of lavender oil. Hypothesis: H0-There will be no significant difference in the effect of lavender oil on episiotomy wound among postnatal mothers. H1- There will be significant difference in the effect of lavender oil on episiotomy wound among postnatal mothers.

Effect of Lavender Oil Drops Application on Perineal Pain Intensity and Episiotomy Wound Healing Among Primiparous Women

Effect of Lavender Oil Drops Application on Perineal Pain Intensity and Episiotomy Wound Healing Among Primiparous Women

Efficacy of Marham-e-Dakhilyun Ointment and Alum Perineal Wash for Perineal Wound Healing and Pain Intensity in Postpartum Women: A Self-control Clinical Trial

Background and Objective:: Episiotomy, worldwide, is the most frequently performed obstetric surgical procedure. Delayed wound healing potentially amplifies the risk of wound infection, structural muscular alterations, and ultimately contributes to the loss of muscle tone. In addition, rapid and complete repair of the episiotomy or perineal tear is very important as the pain and discomfort of episiotomy wounds may affect the quality of life of postnatal mothers. Therefore, we aimed to determine the efficacy of Marham-e-Dakhilyun ointment and alum perineal wash on perineal wound healing and pain intensity in postnatal mothers. Materials and Methods:: A single-arm self-controlled study was conducted on postnatal mothers aged 18 to 40 years, who underwent full-term normal cephalic singleton vaginal delivery with episiotomy and/or 1st, 2nd, or 3rd-degree perineal tears. The recommended external care regimen for a period of 10 days involved perineal wash with a solution of alum powder (2 gm/500ml), followed by the application of Marham-e Dakhilyun ointment twice daily to the perineal wound. For the primary evaluation of wound healing, the REEDA (redness, edema, ecchymosis, discharge, and approximation) scale has been utilized, while the secondary assessment involved the use of the VAS (visual analog scale) pain intensity scale. The therapeutic outcome was determined based on the grading of REEDA scores on days 10-14 and VAS scores. Results:: We observed our trial medicine showed complete wound healing in 86.4% on days 10- 14. The mean pain reduction percentage (PR %) was 96.85% on days 10-14 from baseline. The REEDA score was 2.41±0.81 and 0.23±0.61 at one hour and day 10-14, respectively, with significant differences (p < 0.001). The VAS score was 2.86±1.08 and 0.09±0.29 at one hour and day 10-14, respectively, with significant differences (p < 0.001). Therefore, the trial ointment and alum have demonstrated beneficial effects in promoting perineal wound healing and alleviating pain in postnatal mothers. Conclusion:: The potential efficacy of Marham-e-Dakhilyun can be attributed to its composition of various phytoconstituents, such as oleuropein, phenolic acids, flavonols, flavones, linoleic acid isovitexin, vitexin vanillic acid, salicylic acid, beta-D-glucopyranoside, olanigroside Y1, solasonine, gallic acid, aucubin, scopoletin, and lantamajoside. These constituents have been proven in research studies to possess anti-inflammatory, wound healing, antimicrobial, analgesic, and antioxidant properties. The investigators have optimized the use of these Unani medicines to provide clinical evidence supporting their effectiveness in the wound-healing process and in reducing pain intensity.

“A COMPARATIVE CLINICAL STUDY TO EVALUATE THE EFFICACY OF NIMBAADI LEPA IN THE MANAGEMENT OF PRASUTAA YONI KSHATA WITH SPECIAL REFERENCE TO EPISIOTOMY WOUND.”

Prasutaa Yoni Kshata comes under the category of Sadyovrana, subcategorized as Chinna / Kshta Vrana (cut wound). Despite the rich blood supply of the perineum, which facilitates easy wound healing, there is still a risk of contamination by lochia, faeces, urine, etc., so there is a need for proper care of episiotomy wounds to avoid complications. Study design: An open-labelled randomised control clinical trial with pre-and post-test designs. Materials and methods: 40 Females who underwent normal vaginal delivery with episiotomy were selected and randomly divided into two groups of 20 each. In Group A, Nimbaadi Lepa was applied on the surface of a su-tured episiotomy wound with 1/4th Angula (0.44cms approx.) thickness, and in Group B (control) Kumari Majja with Haridra Lepa was applied two times a day for seven days. Follow-ups: on the 7th and 15th day. Results ob-tained were tabulated and statistically analysed using the Friedman, Wilcoxon signed rank, and Mann- Whitney U tests. Both groups showed statistically significant results within the group. Comparison between 2 groups shows Nimbaadi Lepa is slightly more effective than Kumari Majja with Haridra Lepa. Conclusion: Both the formulations proved effective on statistical value in terms of Vrana shodhana, Vrana ropana, Vedanasthapana, and Shothahara properties for episiotomy wound healing.

The effect of Camellia sinensis ointment on perineal pain and episiotomy wound healing in primiparous women: A triple-blind randomized clinical trial.

Episiotomy is one of the most commonly performed procedures in obstetrics. complications of episiotomy are pain, bleeding, infection, pain in the sitting position, and difficulty in taking care of the baby. This study aimed to investigate the effect of Camellia sinensis ointment on perineal pain and episiotomy wound healing in primiparous women. This triple-blinded randomized clinical trial was conducted on 60 primiparous women who were referred to the maternity ward of Al-Hadi hospital in Shoushtar and Ganjovian hospital in Dezful, Iran, from 2020 to 2021. Participants were randomly assigned into two groups of intervention (Camellia sinensis extract ointment) and control (placebo) with a follow-up of 14 days. REEDA scale (redness, edema, ecchymosis, discharge, and approximation) was used to measure wound healing and the Visual Analog Scale (VAS) was used to measure the pain intensity. There was no significant difference between two groups before intervention in terms of sociodemographic characteristics, pain intensity, and episiotomy wound status. Scores of pain intensity and wound healing reduced on days 7, 10, and 14 post-intervention in the intervention group compared to placebo. There was a significant decrease between the groups of intervention and control in terms of the mean score of pain intensity (VAS scale) on day 10 (1.33 ± 0.71, 1.77 ± 0.93) and day 14 (0.73 ± 0.74, 1.13 ± 0.81) post-intervention (P < 0.05). Also, on day 14 post-intervention, there was a significant decrease between the groups of intervention and control in terms of the mean score of episiotomy wound healing (REEDA index) (0.53 ± 0.77, 1.77 ± 1.46) (P < 0.05). The GLM test was applied for repeated measures. REEDA index and VAS scale changed during different times (time-variable) (p < .001). But, the studied groups (group variable) and the studied groups (interaction effect of group * time) did not affect the changes in the REEDA index (p = .292, p = .306) and VAS scale (p = .47) during different times. Our study showed that Camellia sinensis extract ointment has a small effect on the healing process and pain reduction of episiotomy wounds. to confirm its effect, a study with a larger sample size should be conducted. This trial was registered in the Iranian Registry of Clinical Trials on 04/10/2019 with the IRCT ID: IRCT20190804044428N1. Participants were enrolled between 11 April 2020 and 20 January 2021. URL of registry: https://en.irct.ir/trial/41326.

Could subcutaneous rifampicin administration be an effective approach for reducing episiotomy infections?

The aim of this prospective cross-sectional study was to investigate whether cleaning the episiotomy line with rifampicin solution before suturing will reduce infection and wound dehiscence in women who had vaginal delivery with episiotomy. A prospective cross-sectional study was conducted with a total of 400 primigravida patients. In the study group, irrigation with rifampicin of the subcutaneous tissue of the episiotomy incision was applied, and in the control group, there was no irrigation. Patients were evaluated for infection at the 1st, 3rd week, and 1-month controls. The groups were compared according to episiotomy infection and wound dehiscence rates. The episiotomy infection rate of the whole group was 8.5%, the wound dehiscence rate was 3.75%, and the average time of occurrence of the infection was 5.35±2.21 days. The most common infection findings were local pain and purulent discharge at 4.75%. In the control group, where the infection occurred earlier, the infection and wound dehiscence rates were significantly higher [11.5% vs. 5.5%; 6.0% vs. 1.5% (p<0.05)]. Purulent discharge was the most common finding in the control group, and local pain in the study group, but no significant difference was found between the two groups in terms of findings (p<0.05). When only the patients who developed episiotomy infection were evaluated among themselves, the only significant difference was found in wound dehiscence, which was higher in the control group (p<0.05). Considering the high rates of episiotomy in our country, subcutaneous irrigation with rifampicin is a good option that can be kept in the foreground due to its low cost and ease of application.

Клінічне дослідження ефективності гідрогелевих пов’язок із лідокаїном у зменшенні запалення епізіотомної рани, післяпологового стресу та болю

Episiotomy, like other surgical interventions, triggers inflammatory responses within the physiological context by engaging proinflammatory mediators such as interleukins, cytokines, and prostaglandins. The painful experiences associated with episiotomy have the potential to significantly impact both the physical and emotional well-being of the parturient, particularly when considering individual variables such as the extent of the incision and the presence of complicating factors. In the postpartum period, the presence of fear, anxiety, and anticipation of pain may contribute to heightened stress levels, thereby exerting a profound impact on the emotional state of the parturient. Emotional stress, in turn, has the capacity to modulate pain perception, amplifying the discomfort associated with the incision. Elevated concentrations of stress hormones can influence immune responsiveness and inflammatory cascades, subsequently affecting the intricate process of episiotomy healing. Purpose - to examine determinants influencing the recovery of episiotomy wounds, encompassing inflammation markers, postpartum pain, and psychosocial stress. Materials and methods. A prospective randomized study analyzed clinical, laboratory, and historical data from 123 primiparous patients with episiotomy wounds at Kyiv City Maternity Hospital No. 5 during 2021-2022. The study comprised a comparison group (63 patients receiving standard treatment) and a research group (60 patients additionally utilizing hydrogel dressings with lidocaine). Both groups underwent assessment for heat shock protein Hsp60 and bacterial homolog GroEl levels, serum interleukin-6 dynamics, cortisol levels, pain, and stress levels according to the Edinburgh Postnatal Depression Scale. Statistical analysis employed the Mann-Whitney U test and EZR v. 1.54 statistical package. Results. No statistically significant differences were found in Hsp60 and GroEl levels, interleukin-6, cortisol, and pain levels after 24 hours between the comparison and research groups (p&gt;0.05). However, interleukin-6 levels after 72 hours postpartum were 12.35 pg/ml (10.478-14.09) vs. 6.9 pg/ml (4.50-9.85); p&lt;0.001; cortisol levels - 25.22 μg/dl (23.113-29.335) vs. 23.5 μg/dl (19.6-26.0), respectively; p&lt;0.001. Pain levels by the visual analog scale after 72 hours postpartum were 4 (3-5) points vs. 3 (3-4) points; p&lt;0.001; and at 10 days postpartum - 3 (2-3) points vs. 2 (2-3) points; p=0.010. Stress levels after 72 hours postpartum were 16 (13-19.75) points vs. 11.5 (9-15.5) points; p&lt;0.001. Conclusions. Grasping the intricate interplay of episiotomy, inflammation markers, stress, and pain is pivotal for delivering comprehensive postpartum care. The implementation of evidence-based strategies, such as personalized pain management protocols, psychological support, and systematic monitoring of inflammation markers, can significantly enhance women's well-being and render the postpartum recovery process more comfortable. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Вплив гідрогелевих пов’язок на процес репарації епізіотомної рани

Childbirth is an event that affects the mother both physically and emotionally in the short and long term. About a third of women give birth physiologically, but the rest undergo interventions. One of the most common interventions during birth is the use of an episiotomy, which is the surgical widening of the vaginal opening through an incision in the perineum during the second stage of labor. Accordingly, after the incision, there is a need to create favorable conditions for better healing and restoration of the episiotomy wound. Purpose - to study the effectiveness of hydrogel dressings with lidocaine in the management of episiotomy wounds. Materials and methods. The prospective randomised study analysed clinical, laboratory and anamnestic data of 123 first-time mothers with episiotic wounds (Kyiv City Maternity Hospital No. 5, 2021-2022). Participants were divided into two groups: a comparison group (63 patients), which received standard treatment; a study group (60 patients), which additionally received hydrogel dressings with lidocaine. Wound healing was assessed by the REEDA scale on the 1st, 2nd, 3rd and 10th day after delivery. Statistical analysis was performed using the Mann-Whitney test and the statistical package EZR v. 1.54. Results. The results of the analysis of the total values according to the REEDA scale showed that the process of episiotic wound healing between the two groups of patients proceeded similarly on the 1st day of observation (5 (3.25-6) points - in the comparison group; 4 (3-6) points - in the study group; p=0.589). At the end of the 2nd day of follow-up, the results indicated a statistically significant difference (7 (6-8) points in the comparison group, 6 (4-7.5) points in the study group; p=0.001). The analysis of the sum of points at the end of the 3rd and 10th days of observation showed statistically significant differences (6 (5-7) and 4 (4-5) - in the comparison group (p=0.014); 6 (3-6.5) and 3 (3-4) - in the study group (p&lt;0.001), respectively). Conclusions. The use of hydrogel dressing with lidocaine in the management of the episiotomy wound reduces the scores according to the REEDA scale on the 2nd, 3rd and 10th days after delivery, which indicates a more effective episiotomy healing process compared to patients with a comparison group. Hydrogel dressing with lidocaine contribute to better healing of episiotomy wounds, proving their usefulness in clinical practice. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

A Comparative Study to Evaluate the Effectiveness of Crushed Ice Pack Application and Sitz Bath on Episiotomy Pain and Wound Healing Among Postnatal Mothers

An episiotomy is an incision made in the perineum- the tissue between the vaginal opening and the anus during child birth. Pain at the episiotomy site is more distressing for the mother during postnatal period. An ice pack application or warm shallow bath (sitz bath) may increase comfort and promotes healing. The main aim of this present study was to compare the effect of Crushed ice pack application and Sitz bath on episiotomy pain and wound healing among postnatal mothers. A Matched group design was adopted in this study. By using Non probability purposive sampling technique 22 postnatal mothers with episiotomy were selected as samples at Ramakrishna Hospital, Coimbatore and 11mothers were assigned randomly to each group I and group II. Episiotomy pain was assessed by using Numerical Pain Intensity scale and Wound healing was assessed by using Davidson REEDA scale. Group I received crushed ice pack application and Group II received sitz bath. Intervention was given for 10 minutes twice a day for three consecutive days from first postnatal day. Data were analysed by using descriptive and inferential statistical methods. The statistical analysis revealed that the calculated mean scores of episiotomy pain in the group I and group II was1.72 and 2.9 respectively and the mean difference is 1.2 with the standard deviation of group I and group II was 0.64 and 0.53 respectively. The calculated ‘t’ value 11.3 was greater than the table value of 2.086 at 0.05 level of significance. The calculated mean scores of episiotomy wound healing in the group I and group II was 1.54 and 1.81 respectively and the mean difference is 0.27 with the standard deviation of group I and group II was 0.5 and 0.6 respectively. The calculated‘t’ value 2.6 was greater than the table value of 2.086 at 0.05 level of significance. Finally, the study concluded that the crushed ice pack application was more effective than sitz bath in reducing the level of episiotomy pain and promotes wound healing among postnatal mothers.

Clinical and Aesthetic Review of Episiotomy Wound Closure Methods.

An episiotomy is a surgical incision in the perineum to facilitate the baby's head during delivery. Physicians or midwives may use this procedure if he/she finds out the tissue around the vaginal opening begins tearing or does not seem to be stretching enough to allow the baby to be delivered. With an increasing trend for hospital births and for physicians to get involved in the normal uncomplicated birth process, there was rise in the number of episiotomies. After the baby is delivered through the extended vaginal opening, the area is applied with local anesthetic agent and incision is repaired with sutures. Our study reviewed the development in the past twenty years regarding episiotomy wound closure methods, and discovered that continuous sutures for episiotomy or perineal repair have clinical advantages in term of faster and better wound healing, more favorable scarring, shorter post-procedural pain, more rapid resumption of sexual activity, lower incidence of urinary incontinence, compared to interrupted sutures. They were also beneficial in term of less consumption of suture materials. In determining suture materials, clinicians should strongly consider the tear severity, tissue characteristics, as well as the desired aesthetic outcome.