Gel Pad Research Articles

Phase aberration correction for ultrasound imaging guided extracorporeal shock wave therapy (ESWT): Feasibility study

Image guidance of extracorporeal shock wave therapy (ESWT) is important to enhance its efficacy while lowering pain in patients. Real-time ultrasound imaging is an appropriate modality for image guidance, but its image quality substantially reduces due to severe phase aberration from the different speed of sound between soft tissues and a gel pad, which is utilized to control a therapeutic focal point in ESWT. This paper presents a phase aberration correction method for improving image quality in the ultrasound imaging guided ESWT. To correct an error from phase aberration, a time delay based on a two-layer model with different speeds of sound is calculated for dynamic receive beamforming. For the phantom and in vivo studies, a rubber type gel pad (i.e., 1400 m/s) with a specific thickness (3 or 5-cm) was placed on the top of soft tissue and full scanline RF data were acquired. In the phantom study, with phase aberration correction, image quality was highly increased compared to image reconstructions with a fixed speed of sound (i.e., 1540 or 1400 m/s), i.e., 1.1 vs. 2.2 and 1.3 mm in −6dB lateral resolution and 0.64 vs. 0.61 and 0.56 in contrast-to-noise ratio (CNR), respectively. From an in vivo musculoskeletal (MSK) imaging, the phase aberration correction method provided a clearly improved depiction of muscle fibers in a rectus femoris region. These results indicate that the proposed method enables effective imaging guidance of ESWT by improving image quality of ultrasound imaging in real-time.

Enhanced thermal performance from liquid metal in copper/graphite filled elastomer

With the increasing integration level of modern electronics, thermal management becomes an urgent issue for guaranteeing the work efficiency and lifespan of electronics. On the basis of intrinsic high thermal conductivity nature, highly ordered graphite and copper stripes are densely aligned in the silicone gel pads in vertical (VCuGr) and oblique (@15°CuGr) directions to couple the high thermal conductivity and mechanical softness. The wetting nature of liquid metal (LM) on the chemically treated Cu surface is utilized to form a LM layer on the two surfaces of thermal pads. The obtained LM-pad TIMs possessed ultrahigh through-plane thermal conductivity (VCuGr: 71.4 W/(m K), @15°CuGr: 62.5 W/(m K)) under the normal packaging pressure. The thermal resistance decreased from 0.69 cm2 K/W to 0.25 cm2 K/W with the surface modification with LM. Theoretical simulation and practical thermal dissipation test results further demonstrate the excellent thermal management capability of these composites in high-power electronics.

Investigation of the contribution of viscoelastic polymer gel pad usage to the accuracy of magnetic resonance elastography measurements: A preliminary study

Investigation of the contribution of viscoelastic polymer gel pad usage to the accuracy of magnetic resonance elastography measurements: A preliminary study

Automated breast ultrasound (ABUS) for intraoperative margin control on surgical specimens in breast conserving surgery.

As breast-conserving surgery (BCS) has become the standard for treatment of early breast cancer, the need for new technologies to improve intraoperative margin assessment has become clear. Close or positive margins during BCS lead to additional surgeries, treatment delay, additional stress for patients and increasing healthcare cost. Automated three-dimensional breast ultrasound (ABUS) systems are meant to overcome the shortcomings of hand-held ultrasound (HHUS). In this study, we investigate the feasibility of ABUS to conduct ultrasound on surgical specimens in breast conserving therapy. In this monocentric, non-interventional study, specimens of 40 women were examined via ABUS. A construction with isotonic saline solution, gel pads and ABUS membranes was invented by our team to produce images of breast cancer specimens using ABUS. Evaluation of the ABUS images was carried out by two independent physicians trained on ABUS evaluation. ABUS was conducted on 40 specimens. 90% of the generated images were of high quality. Measured tumor sizes with ABUS were bigger than measured tumor size with HHUS (mean tumor size 22.9 vs. 18.1mm, CI 2.38-7.35, p < 0.05). The mean difference between the ABUS tumor size and the pathological tumor size was 1.8mm (CI -0.84-4.53, p = 0.17). The mean difference between the HHUS tumor size and the pathological tumor size was 3.2mm (CI -5.35 to -1.03, p = 0.005). ABUS seems to be a suitable method to conduct specimen ultrasound. Further studies are required to evaluate the accuracy of ABUS for intraoperative margin assessment and possible implementation in clinical work routine.

In-Situ Functionalization of Cotton Fabric by TiO2: The Influence of Application Routes

The desirable chemical, physical, electronic, and optical properties of TiO2, as well as its high availability, non-toxicity, and low price, make it very popular in the modern functional textile industry. Here, TiO2 from titanium tetraisopropoxide (TTIP) precursors at concentrations of 2, 4, and 6% and commercial TiO2 nanoparticles (NPs) in dispersion form were applied to cotton textiles using low-temperature application methods (i.e., sol–gel pad–dry–cure, pad–hydrothermal, and exhaustion–hydrothermal methods) to provide a systematic study of the influence of low-temperature application processes and TIIP concentration and on the overall properties of TiO2-functionalized textile materials. The treated cotton fabric samples were characterized using scanning electron microscopy (SEM), energy dispersive X-ray analysis (EDS), Fourier transform infrared spectroscopy (FT-IR), and X-ray diffraction spectroscopy (XRD) to determine their surface morphology, chemical composition, and crystal structure, while the optical properties of the synthesized TiO2 were determined using the absorption method and Tauc plotting. Afterwards, corresponding UV protection properties and photocatalytic self-cleaning activity were evaluated. In contrast to commercial TiO2, a relatively thin TiO2 deposition with an amorphous structure and a blue-shifted band gap between 3.18 and 3.28 eV was formed when applied at low temperatures. A sol with a TIIP concentrations of 2 and 4% applied using the exhaustion–hydrothermal and sol–gel dry-cure method, respectively, proved to be optimal. Both applied sol concentrations provided good UV protection and excellent photocatalytic performance, which exceeded that of commercial TiO2, even though the Ti contents in the samples were two- to three-times lower and the synthesized TiO2 exhibited an amorphous structure.

Ultrasound Transducer Pressure: An Unexplored Source of Abdominal Aortic Aneurysm Measurement Error.

This study was aimed at quantifying the abdominal aortic aneurysm (AAA) compression phenomenon and assessing the use of a new tool to estimate transducer pressure in vivo. In this cross-sectional study, 47 participants with AAA and a median anterior-to-posterior (AP) AAA diameter of 46 mm (range: 30-76 mm) were included. The majority of the patients were overweight with body mass indexes >25 (33/47, 70%). A standardized ultrasound (US)-compatible gel pad, with a pre-defined thickness (15 mm) and mass (150 g), was interposed between the US transducer and participant to estimate the applied transducer pressure. A firm transducer pressure significantly lowered the median AP diameter from 46.1 mm (range: 29.7-76.3) to 39.4 mm (range: 21.7-67.5) (p=0.001). The mean diameter bias between light and firm transducer pressure was 6.1 mm (95% confidence interval: 4.9-7.3). The applied transducer pressure varied significantly and could be measured by translating the deformation of a low-tech gel pad interposed between the US transducer and the participant.

Mechanical validation of viscoelastic parameters for different interface pressures using the Kelvin-Voigt fractional derivative model.

The knowledge of the biomechanical properties of tissues is useful for different applications such as disease diagnosis and treatment monitoring. Reverberant Shear Wave Elastography (RSWE) is an approach that has reduced the restrictions on wave generation to characterize the shear wave velocity over a range of frequencies. This approach is based on the generation of a reverberant field that is generated by the reflections of waves from inhomogeneities and tissue boundaries that exist in the tissue. The Kelvin-Voigt Fractional Derivative model is commonly used to characterize elasticity and viscosity of soft tissue when using shear wave ultrasound elatography. These viscoelastic characteristics can be then validated using mechanical measurements (MM) such as stress relaxation. During RSWE acquisition, the effect of interface pressure, induced by pushing the probe on the skin through the gel pad, on the viscous and elastic characteristics of tissue can be investigated. However, the effect of interface pressure on the validity of the extracted viscous and elastic characteristics was not investigated before. Therefore, the purpose of this study was to compare the estimation of the viscoelastic parameters at different thickness of gel pad against the viscoelastic characteristics obtained from MM. The experiments were conducted in a tissue-mimicking phantom. The results confirm that the relaxed elastic constant (μ0) can be depreciated. In addition, a higher congruence was found in the viscous parameter (ηα) estimated at 6 and 7 mm. On the other hand, a difference in the order of fractional derivative (α) was found.

Efficacy of Cabbage Leaf versus Cooling Gel Pad or Diclofenac Gel for Patients with Knee Osteoarthritis: A Randomized Open-Labeled Controlled Clinical Trial.

Background Osteoarthritis (OA) is one of the most common joint degeneration ailments adversely affecting the elderly population by impairing their physical movements and quality of life. This study aimed to establish the efficacy of cabbage leaf application in alleviating pain-related distress and positively improving OA conditions. Materials and Methods Patients with moderate to severe (grades 3-4) OA by the Kellgren and Lawrence grading system with a poor to good Oxford Knee Score were selected for enrollment in this clinical trial. The participants were divided into three intervention groups: the cooling gel pad group for 20 minutes duration once a day (n = 20), the diclofenac gel group for 4 times a day (n = 20) as the control group (total n = 40), and the cabbage leaf group for 1-hour duration once a day (n = 20) as the experimental group (total n = 20). All trial participants were trained to record their Numerical Rating Scale (NRS) pain score and Oxford Knee Score and were advised to undergo weekly follow-ups and assessment of the outcome at 4 weeks. Data were analyzed by the paired t-test and analysis of variance (ANOVA). Results The cabbage leaf group and cooling gel pad group showed a significant difference in both the Oxford Knee Score (p < 0.001 in both groups) and NRS score (p < 0.001 in both groups) before and after the intervention, by using the paired t-test. The three study procedures were found to be significantly different with respect to both the Oxford Knee Score (p=0.012) and NRS score (p < 0.001), by using ANOVA. Conclusion This study clinically demonstrated that cabbage leaf application and cooling gel pad application showed similar improvements in reducing OA symptoms in terms of the overall NRS score and Oxford Knee Score. Their therapeutic effectiveness was better than that of diclofenac gel.

A New Safe and Ergonomic Manipulation Tool for the Flank-Free Supine Position: "U-Pad".

Introduction: One of the most important problems in the supine percutaneous approach to the kidney is the narrow surgical surface area (SSA) in the lumbar region. Herein, the spatial and angular geometric advantages of the U-shaped lumbar pad (U-Pad) used as a new positioning tool for safety and ergonomics in the supine percutaneous approach have been revealed. Materials and Methods: Data of patients who underwent endoscopic combined intrarenal surgery (ECIRS) using the U-Pad for kidney stones between March and September 2021 were prospectively collected. The demographic, preoperative, operative, and postoperative data of patients have been saved. The patients were positioned first with the standard gel pad (group 1) and then with the U-Pad (group 2). Both SSA (X and X+Y, cm2) and angular degree (α and β,°) calculations were compared. Fluoroscopy images with the same settings (97 kV/3.00 mA) were visually compared. In geometric data, trapezoidal area formula [(upper base + lower base) × height/2] and goniometer were used to compare with paired t-test. Results: ECIRS was performed on 17 patients, 13 men and 4 women, with a median age of 39 (range 32-47). The median body mass index was 26.2 (23.5-29.1). Stone localization and features were recorded. The median SSA was calculated as 35.7 cm2 in group 1 and 97.3 cm2 in group 2, and it was calculated that the total SSA increased to 272.5% with a median of 61.6 cm2 extra surgical area. Similarly, the downward manipulation angle was 32° (α°) in group 1, whereas it was 60.6° (β°) in group 2, and the median extra motion angle was calculated as 28.6° (89.3%). Conclusion: The U-Pad is a safe and rapid tool in the supine percutaneous approach to the kidney, providing at least two times the extra SSA and manipulation angle.

3D Printed Customized Facemask for Maxillary Protraction in the Early Treatment of a Class III Malocclusion: Proof-of-Concept Clinical Case.

In order to improve fit and comfort, a maxillary protraction facemask customized to the patient’s anatomy was produced by means of 3D face scanning, digital design and additive manufacturing. An 8-year-old patient in need of early treatment for the Class III malocclusion received a rapid palatal expander and a Petit-type facemask, whose components were digitally designed on a 3D scan of the patient’s face. For face scanning, the iPad Pro 2018 tablet (Apple, Cupertino, CA, USA) with the Bellus3D DentalPro application (Bellus3D, Campbell, CA, USA) was used. Facemask components were modelled with 3D Blender software. The rests were 3D printed in BioMed Clear biocompatible resin (Formlabs, Somerville, MA, USA), and the bar in stainless steel. For greater comfort, the internal surface of the rests was lined with a polymer gel pad (Silipos, Niagara Falls, NY, USA). The manufacturing procedure of the customized facemask is patented. The patient wore the facemask at night for a period of 9 months. The patient’s experience was evaluated with a questionnaire at 1 week, 3, 6, and 10 months of treatment. The customized facemask was well accepted by the patient and obtained the expected treatment outcome. Furthermore, 3D face scanning, 3D modelling and 3D printing allow for the manufacturing of customized facemasks with improved fit and comfort, favoring patient compliance and treatment success.

Arterial Line Placement Pitfalls Can Be Demonstrated and Visualized With an Inexpensive, Wearable Trainer.

Radial arterial line placement is commonly performed in various clinical settings, including the emergency department. However, learners are successful on the first attempt only half of the time. Simulation can provide learners with procedure practice opportunities outside of clinical practice to increase confidence and chances of success. We set out to build an arterial line trainer that would be inexpensive and reusable, wearable, anatomically realistic, and echogenic to allow for ultrasound use. We also hoped to devise a clear option that would allow for demonstration of procedure pitfalls. The arterial line trainer requires 4 hours of assembly time and costs $160. This includes enough material to make 48 tissue pads. The ballistics gel pad is echogenic; it can be customized with clear gel for direct anatomic visualization or dyed gel for more realism. The trainer also has a pulsatile artery for practice using anatomic landmarks. Visualization of the following important arterial line placement pitfalls is possible: suboptimal angle of approach, inadequate advancement of the catheter, and through-and-through vessel puncture. Our inexpensive trainer can help physicians and physicians in training conceptualize, practice, and troubleshoot the pitfalls of arterial line placement. Training programs looking to help learners understand the mechanics of arterial line placement may find it a useful tool.

Medical device related pressure injuries in COVID-19 patients followed up in an intensive care unit

Aim: The aim of this study is to determine the prevalence of medical device-related pressure injuries in COVID-19 patients.&#x0D; Material and Method: This study was conducted with a cross-sectional and retrospective design. The data of 436 patients who were followed up and treated in the Anesthesia and Reanimation Intensive Care Unit with the diagnosis of COVID-19 disease between 11.03.2020- 31.02.2021 in a Training and Research Hospital in İstanbul were included in the study. The sample of the study consisted of 32 patients out of 436 patients who met the sampling criteria. The data obtained by retrospective reviewing of the patient records were analyzed through the "Patient Information Form" and "Pressure Injury Stage" forms.&#x0D; Results: Medical device-related pressure injury developed in 32 (7.3%) of 436 patients examined in the study on the specified dates. 90.6% of these patients were male, and the average age was 67.5. 43.7% had comorbid diseases. According to the Braden Risk Assessment Scale, 25% of these patients had medium and 71.8% high risk. Medical devices that cause pressure injury were continuous positive airway pressure mask (n=13), intubation tube (n=7), nasogastric tube (n=5), nasal cannula (n=3), gel pads (n=3), and oxygen mask (n=1).&#x0D; Conclusion: In this study, the potential factors in the study that may have led to the incidence of medical device-related pressure injury specific to COVID-19 disease include the rapid increase in the need for respiratory support, ischemia caused by this infection, and the use of prone position.

Adoption of CHG impregnated transparent gel pad dressing on haemodialysis patient population with long-term central venous access

Adoption of CHG impregnated transparent gel pad dressing on haemodialysis patient population with long-term central venous access

Plantar Soft Tissue Characterization Using Reverberant Shear Wave Elastography: A Proof-of-Concept Study

Plantar soft tissue stiffness provides relevant information on biomechanical characteristics of the foot. Therefore, appropriate monitoring of foot elasticity could be useful for diagnosis, treatment or health care of people with complex pathologies such as a diabetic foot. In this work, the reliability of reverberant shear wave elastography (RSWE) applied to plantar soft tissue was investigated. Shear wave speed (SWS) measurements were estimated at the plantar soft tissue at the first metatarsal head, the third metatarsal head and the heel from both feet in five healthy volunteers. Experiments were repeated for a test-retest analysis with and without the use of gel pad using a mechanical excitation frequency range between 400 and 600 Hz. Statistical analysis was performed to evaluate the reliability of the SWS estimations. In addition, the results were compared against those obtained with a commercially available shear wave-based elastography technique, supersonic imaging (SSI). The results indicate a low coefficient of variation for test-retest experiments with gel pad (median: 5.59%) and without gel pad (median: 5.83%). Additionally, the values of the SWS measurements increase at higher frequencies (median values: 2.11 m/s at 400 Hz, 2.16 m/s at 450 Hz, 2.24 m/s at 500 Hz, 2.21 m/s at 550 Hz and 2.31 m/s at 600 Hz), consistent with previous reports at lower frequencies. The SWSs at the plantar soft tissue at the first metatarsal head, third metatarsal head and heel were found be significantly (p<0.05) different, with median values of 2.42, 2.16 and 2.03 m/s, respectively which indicates the ability of the method to differentiate between shear wave speeds at different anatomical locations. The results indicated better elastographic signal-to-noise ratios with RSWE compared to SSI because of the artifacts presented in the SWS generation. These preliminary results indicate that the RSWE approach can be used to estimate the plantar soft tissue elasticity, which may have great potential to better evaluate changes in biomechanical characteristics of the foot.

Impact of cooling method on the outcome of initial shockable or non-shockable out of hospital cardiac arrest patients receiving target temperature management: a nationwide multicentre cohort study

BackgroundLittle is known about the effectiveness of surface cooling (SC) and endovascular cooling (EC) on the outcome of out-of-hospital cardiac arrest (OHCA) patients receiving target temperature management (TTM) according to their initial rhythm.MethodsWe retrospectively analysed data from the Japanese Association for Acute Medicine Out‐of‐Hospital Cardiac Arrest registry, a multicentre, prospective nationwide database in Japan. For our analysis, OHCA patients aged ≥ 18 years who were treated with TTM between June 2014 and December 2017 were included. The primary outcome was 30-day survival with favourable neurological outcome defined as a Glasgow–Pittsburgh cerebral performance category score of 1 or 2. Cooling methods were divided into the following groups: SC (ice packs, fans, air blankets, and surface gel pads) and EC (endovascular catheters and any dialysis technique). We investigated the efficacy of the two categories of cooling methods in two different patient groups divided according to their initially documented rhythm at the scene (shockable or non-shockable) using multivariable logistic regression analysis and propensity score analysis with inverse probability weighting (IPW).ResultsIn the final analysis, 1082 patients were included. Of these, 513 (47.4%) had an initial shockable rhythm and 569 (52.6%) had an initial non-shockable rhythm. The proportion of patients with favourable neurological outcomes in SC and EC was 59.9% vs. 58.3% (264/441 vs. 42/72), and 11.8% (58/490) vs. 21.5% (17/79) in the initial shockable patients and the initial non-shockable patients, respectively. In the multivariable logistic regression analysis, differences between the two cooling methods were not observed among the initial shockable patients (adjusted odd ratio [AOR] 1.51, 95% CI 0.76–3.03), while EC was associated with better neurological outcome among the initial non-shockable patients (AOR 2.21, 95% CI 1.19–4.11). This association was constant in propensity score analysis with IPW (OR 1.40, 95% CI 0.83–2.36; OR 1.87, 95% CI 1.01–3.47 among the initial shockable and non-shockable patients, respectively).ConclusionWe suggested that the use of EC was associated with better neurological outcomes in OHCA patients with initial non-shockable rhythm, but not in those with initial shockable rhythm. A TTM implementation strategy based on initial rhythm may be important.

TP7.2.4 Skin-to-gel is a safe and effective method to prevent patients sliding during minimally invasive colorectal surgery

Abstract Aims Minimally invasive colorectal surgery often requires manipulating the patient position to facilitate exposure of the surgical field, such as a steep Trendelenburg position. However, this exposes patients to risks of sliding on the operating table. Preventive interventions are available, such as bean bags; we explore our experiences of gel pads within a district general hospital. Methods A retrospective analysis was performed of all colorectal patients undergoing laparoscopic resections over the last ten years, identifying complications associated with the use of intra-operative gel pads (skin-to-gel) with no shoulder support. Results Over 500 patients have undergone laparoscopic colorectal resections during this time, all utilising pressure-relieving gel pads. Patients are placed skin-to-gel, lying on a single torso-length gel pad laid directly on the operating table mattress. Dependent upon the operative approach, the legs can be placed in stirrups or maintained supine on table extensions. There have been no DATIX recorded skin-tears, pressure or position-related injuries. The pads have also proven to prevent patient movement on the operating table, negating the use of shoulder supports when adopting the Trendelenburg position. On discussions with theatre staff, the Consultant body and interrogation of the DATIX database, there has only been one reported incidence of slipping when a patient was left on the slide sheet on top of the gel pad. They are relatively inexpensive, durable and easily maintained, proving a highly cost-effective piece of equipment. Conclusion Gel pads have proven to be highly effective in preventing both pressure-related injuries and patient movement during laparoscopic surgery.

Effect of different cold application materials on pain during chest tube removal: three-arm randomized controlled clinical trial

Chest tube causes severe pain during removal because it attaches to the endothelium in the chest cavity. This study aimed to determine the effectiveness of cold application with ice pack and gel pad in the control of pain experienced during chest tube removal. The sample of prospective, parallel three-arm (1:1:1), randomized controlled clinical trial consisted of 180 patients in two experimental groups (ice pack/gel pad) and one control group. The primary outcome was effect of cold application materials on severity of pain during chest removal. Secondary outcomes were duration of cold application and analgesic requirements of the patients. The study found that the cold application using either of the materials reduced the severity of pain and the need for analgesics after the removal of chest tube compared to the control group (p<0.05). But cold application with ice pack allowed the skin to drop to the temperature effective in pain control in a shorter time than gel pad application (p<0.05). Despite entirely covering the area around the chest tube, the gel pad was more disadvantageous than ice pack in pain control due to the longer duration of cold application.

Beds, overlays and mattresses for preventing and treating pressure ulcers: an overview of Cochrane Reviews and network meta-analysis.

Beds, overlays and mattresses for preventing and treating pressure ulcers: an overview of Cochrane Reviews and network meta-analysis.

Development of a Resting Energy Expenditure Estimation in Patients Undergoing Targeted Temperature Management with a Surface Gel Pad Temperature Modulating Device.

Targeted temperature management (TTM) directly impacts energy expenditure via temperature modulation and shivering associated with temperature modulating devices. We hypothesized that resting energy expenditure (REE) can be accurately estimated utilizing data obtained from a surface gel pad temperature modulating device (TMD) and demographic factors. Baseline demographic data, along with concurrent temperature, sedation, and shivering data, and indirect calorimetry (IDC) were collected from patients undergoing TTM. The data from the IDC and temperature modulation device (TMD) were synchronized and averaged over 60-second intervals to provide simultaneous comparisons. Heat transfer (calories) was calculated from the TMD by an equation that assessed water temperature from the TMD to the patient, water temperature returning to the TMD, water flow rates, and device mode. A linear regression model was used to determine factors associated with REE as measured by IDC. A difference in the mean between REE and estimated REE was used to assess accuracy. There were 48 assessments conducted in 40 subjects [mean (standard deviation)] age: 58 (14) years, 60% female, body surface area (BSA): 2.0 ± 0.3 who underwent simultaneous assessments. Target temperature was 36-37°C in 75%, with a median Bedside Shivering Assessment Score of 0 (range 0-2). Factors associated with REE on multivariable linear regression included older age (p < 0.001), male sex (p = 0.004), higher BSA (p < 0.001), higher patient temperature (p < 0.001), and lower heat transfer (p = 0.003). Adjusted prediction coefficients from this model were then tested against REE by a Bland-Altman analysis. The difference between difference in resting energy estimation (REEdiff) and measured REE by IDC was 6.2 calories/min (REEdiff: 95% confidence interval: -14.1 calories, 26.5 calories, p = 0.5). We believe that the heat transfer data from the TMD coupled with clinical characteristics of patients can be utilized to calculate the REE for every minute of TTM. These data can be utilized to mitigate the consequences of shivering and malnutrition during TTM.

The effect of cold application on episiotomy pain: A systematic review and meta-analysis.

To evaluate the effectiveness of cold application methods in reducing postpartum episiotomy pain. Many women suffer from pain after giving birth due to an episiotomy. This prolonged pain affects their daily lives as they recover. Various methods can help alleviate this pain; however, the effects of cold application specifically are still under discussion. Systematic review and meta-analysis were used. In this review, we investigated studies from the CINAHL, PubMed, Google Scholar and Science Direct databases that met PICOS inclusion criteria. We also assessed the studies' methodological quality with the JADAD and JBI checklists. This study was performed based on the Guidelines of Systematic Reporting of Examination presented in the PRISMA checklist (Appendix S1). The search protocol has been registered at the PROSPERO International Prospective Register of Systematic Reviews. A total of seven published studies including 700 total participants were included in this review. Various cold application methods (cold gel pack/pad, crushed ice gel pad, ice pack) significantly reduced the pain after an episiotomy. Ice packs in particular did not significantly differ from lavender oil and acupressure in reducing pain after an episiotomy. Cold application methods can be an effective, non-pharmacological midwifery and nursing intervention to reduce pain after an episiotomy. The use of cold application methods to reduce pain after episiotomy may reduce the need for pharmacological medication in women due to the reduction in pain in the perineum.