Perineal Wound Research Articles

Bladder preservation or complete cystectomy during pelvic exenteration of patients with locally advanced or recurrent rectal cancer, what should we do?

IntroductionIn patients with locally advanced (LARC) or locally recurrent (LRRC) rectal cancer and bladder involvement, pelvic exenteration (PE) with partial (PC) or radical (RC) cystectomy can potentially offer a cure. The study aim was to compare PC and RC in PE patients in terms of oncological outcome, post-operative complications and quality-of-life (QoL). Materials & methodsThis was a retrospective cohort analysis of a prospectively maintained surgical database. Patients who underwent PE for LARC or LRRC cancer with bladder involvement between 1998 and 2021 were included. Post-operative complications and overall survival were compared between patients with PC and RC. Results60 PC patients and 269 RC patients were included. Overall R0 resection was 84.3%. Patients with LRRC and PC had poorest oncological outcome with 69% R0 resection; patients with LARC and PC demonstrated highest R0 rate of 96.3% (P = 0.008). Overall, 1-, 3- and 5-year OS was 90.8%, 68.1% and 58.6% after PC, and 88.7%, 62.2% and 49.5% after RC. Rates of urinary sepsis or urological leaks did not differ between groups, however, RC patients experienced significantly higher rates of perineal wound- and flap-related complications (39.8% vs 25.0%, P = 0.032). ConclusionPC as part of PE can be performed safely with good oncological outcome in patients with LARC. In patients with LRRC, PC results in poor oncological outcome and a more aggressive surgical approach with RC seems justified. The main benefit of PC is a reduction in wound related complications compared to RC, although more urological re-interventions are observed in this group.

Delayed vs. early enteral feeding after repair of congenital recto-vestibular fistula: The effect on perineal wound healing.

congenital Recto vestibular fistula represents the commonest type of anorectal malformation in females. The treatment of this anomaly is mainly approached either through anterior or posterior sagittal ano-rectoplasty approach. Several perioperative factors may affect the outcome. One of major postoperative complications is the occurrence of wound infection. We aimed to study the effect of delayed vs. early enteral feeding on the occurrence of perineal wound infection (PWI) after repair of congenital recto vestibular fistula. Fifty-five infants with recto-vestibular fistula were included. They were managed by single stage anterior sagittal anorectoplasty (ASARP) at an age ≥3 months. Groups A and B included infants who started oral intake on the 6th and 2nd postoperative days respectively. Group A infants were kept on peripheral parenteral nutrition (PPN) during the fasting period. Superficial wound infection occurred in three cases in group A while it developed in seven cases in group B. Deep perineal infection occurred in two and five cases in group A and group B respectively. The mean hospital stay was 8 days in group A vs. 13 days in group B when PWI developed. Delayed enteral feeding with PPN keeps the perineal wound less contaminated with stool. This promoted proper and fast healing with lower incidence of PWI. Also, PPN compensates the catabolic effects of both surgical trauma and fasting during the postoperative period and ensures maintenance of normal levels of essential nutrients that allow for proper healing.

Effect of Dry Heat Application on Perineal Pain and Episiotomy Wound Healing among Primipara Women.

Women who undergo perineal episiotomy can be affected by several complications such as bleeding, infection, perineal pain, dyspareunia, reduction of sexual desire, as well as urinary and anal incontinence. Perineal pain related to episiotomy has been reported to interfere with women's daily activities postpartum and can prevent proper breastfeeding, proper rooming-in, and maternal-infant bonding. The purpose of this study was to determine the effect of dry heat application on perineal pain and episiotomy wound Healing among primipara women. A quasi-experimental, two-group, pre-post-test research study was conducted at the postnatal inpatient ward and the outpatient clinic of the El-Shatby Maternity University Hospital in Alexandria. A sample of 100 parturient women was divided into the following two groups at random: dry heat and moist (control) heat. Women in the moist heat group were advised to sit in a basin (tub) of warm water for 10 minutes, while those in the dry heat group were instructed to set an infrared light (230 volts) at a distance of 45 cm from the perineum after 12 hours post episiotomy. Both interventions were applied twice a day for ten consecutive days. They evaluated the severity of their perineal pain at baseline and repeated it on the 5th and 10th days after obtaining the interventions while the episiotomy wound healing was assessed on the 5th and 10th days. It was discovered that the dry heat group had a significantly improved episiotomy wound healing as regards perineal redness, edema of the perineal area, ecchymosis, wound discharge, and approximation of wound edges on the 5th (P < 0.001, P < 0.001, P < 0.007, P < 0.003, and P < 0.001, respectively) and 10th day after intervention (P < 0.001, P < 0.001, P < 0.001, P < 0.005, and P < 0.001, respectively) than the moist heat group. The primipara women had significantly lower perineal pain intensity in the dry heat group on the 5th and 10th days after intervention than in the moist heat group (MH P < 0.001 for the dry heat group and MH P = 0.004 for the moist heat group). The application of dry heat promoted episiotomy wound healing among primipara women and reduced their perineal pain during early postpartum days than moist heat.

Effects of wound infection on prognosis after laparoscopic abdominoperineal resection of rectal cancer.

In two facilities in Chongqing, this research sought to retrospectively evaluate the effects of perineal wound infection on survival after laparoscopic abdominoperineal resection (LAPR) of rectal cancer. To obtain clinical information on patients who underwent LAPR between January 2013 and December 2021, we performed a multicenter cohort study. A total of 473 patients were enrolled: 314 in the non-infection group and 159 in the group with perineal infection. The general data, perioperative conditions, and tumor outcomes between groups were analyzed. The infection rates, recurrence rates, and survival rates of the two centers were compared. The age, height, weight, body mass index (BMI), preoperative complications, preoperative treatment, and intraoperative conditions of patients in the LAPR infection group were not statistically different from those in the non-infection group. The percentage of men, typical postoperative hospital stay, length of initial postoperative therapy, and recurrence and metastasis rates were all considerably higher in the infection group than those in the non-infection group. Wound infection was an independent factor affecting tumor recurrence and metastasis after LAPR as well as an independent factor shortening patient survival time according to multivariate analysis. The incidence of wound infection, the rate of recurrence, and the rate of mortality did not vary significantly across sites. Wound infection after LAPR increases the mean postoperative hospital stay, prolongs the time to first postoperative treatment, and decreases the disease-free survival (DFS) and overall survival (OS). Therefore, decreasing the rate of LAPR wound infection is expected to shorten the postoperative hospital stay and prolong the patient DFS and OS. Patients with postoperative infection may require intensive adjuvant therapy.

A Literature Review on Postpartum Perineal Wound Care: Epidemiology, Impact, and Future Interventions

BACKGROUND: Perineal injury is an injury to the urogenital diaphragm and levator ani muscle, which occurs during normal delivery, or vaginal delivery, can occur without injury to the perineal or vaginal skin. Perineal wounds become one of the breeding media for germs so that it becomes the cause of puerperal infection. Perineal infection can occur because the location of the perineum is moist so that it becomes a breeding ground for bacteria. Incidence of infection that occurs in the perineal wound can spread to the birth canal or urinary tract. Infectious conditions in the perineal wound will slow down the wound healing process, because it can increase the damage to the supporting tissues of the skin. AIM: This systematic review aims to see how postnatal perineal wound care: Epidemiology, impact, and future interventions. METHODS: Researchers searched for quantitative studies published between 2017 and 2021, using PubMed, Elsevier, and Google Scholar. Thirty studies in systematics review. RESULTS: The studies that have been collected that there are nine studies discussing the effect of therapies given to the treatment of perineal wounds in studies that discuss therapy two studies including discussing infrared lamp therapy, one study discussing the effects of mastic oleoresin, one study discussing betel leaf decoction, one study discussing the effectiveness of Aloe vera, one study discussing the effects of cinnamon, one study discussed the application of negative pressure sores, one study discussed the effect of pineapple fruit juice, and one other study discussed the effects of carvacrol, tymol, and olive oil. Then, two studies discussed the prevalence of perineal wound events and three studies discussed the characteristics of perineum wounds. CONCLUSION: This systematic review evaluates and synthesizes the effectiveness of intervention methods of perineal wound pain reduction and perineal wound healing (episiotomy) and improves comfort in consideration of the methodological evidence level of stud patients’ comfort.

Autologous Platelet-rich Plasma for the Treatment of Nonhealing Perineal Wounds: A Report of Two Cases

Introduction. Patients with perineal wounds often encounter difficulty in local wound healing after hemorrhoidectomies. PRP contains a high concentration of platelets and has been used to improve wound healing. Objective. In this case study, PRP was used in the treatment of nonhealing perineal wounds to expedite wound healing. Case Reports. The 2 patients in these cases suffered from perineal wounds that were nonhealing for more than 2 months. After assessment of their physical condition, autologous PRP was used in the treatment of both patients. A total of 150 mL of peripheral blood was collected from each patient to prepare autologous PRP in a completely enclosed environment. For one patient, the PRP product was injected subcutaneously around the wound. The rest of the PRP product was activated into a gel by thrombin and calcium chloride, and the gel was applied to the surface of the wound with dressing changes every 5 days. The other patient was externally treated with autologous PRP gel, and dressing changes were administered after a week. The 2 patients were treated twice with PRP, and both completely recovered within 2 weeks without any other treatment. Conclusion. As an autologous blood-derived product, PRP was safe and showed promising results in perineal wound healing.

Introducing a novel technique to reduce severe perineal injuries during delivery: the “shoulder-up” maneuver

To investigate if introducing a novel technique to assist the delivery of the posterior shoulder (the “shoulder-up” maneuver) in a tertiary referral unit may positively impact on the rate of severe perineal injuries. Single-center retrospective interventional study including all vaginal deliveries between April 1st 2020 and March 31st 2022. On March 1st, 2021, a bundle to raise the awareness on the perineal wounds prevention at the delivery of posterior shoulder had been introduced. The “shoulder-up” maneuver, which consists in a slow, controlled delivery of the posterior shoulder under direct visualization of perineal plane after the disengagement of anterior shoulder (see the attached figure), had been included as a standard of care. All midwives and physicians completed a full theoretical and practical course to learn the maneuver at the moment of the bundle introduction. A propensity score matching analysis was performed to assess the effect of the “shoulder-up” maneuver on the risk of perineal tears adjusting for those variables that resulted to be independently associated to more severe perineal injury (nulliparity, gestational age at delivery, peridural analgesia, vacuum extraction and birthweight > 4Kg at delivery). We matched a total of 3652 patients (1826 per arm); the analysis showed a significant increase in intact perineum rate (59.5% vs 66.4%, p = 0.009) and a significant reduction in the incidence of 2nd (30.7% vs 25.8%, p = 0.006) and 3rd-4th degree perineal wounds (2.8% vs 1.2%, p < .001) after the introduction of the bundle. Episiotomy rate did not significantly change before and after the maneuver adoption (7.0 % vs 6.5%, p = 0.702). Our study showed that after the introduction of the “shoulder-up” maneuver as a standard of care in the assistance to vaginal delivery the rate of severe perineal wounds significantly decreased.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

PERINEOTOMY CARE AFTER CHILDBIRTH

Every woman who became pregnant has to undergo the process of delivery. In normal process of delivery the baby is delivered per vagina, an episiotomy is performed by health care provider or midwife. Episiotomy is a surgically planned incision on the perineum and the posterior vaginal wall during the second stage of labour to enlarge the vaginal introits so as to facilitate easy and safe delivery of the fetus. Episiotomy may be advice in the situations such as inelastic perineum, fetal distress, and complicated birth, prolonged second stage of labor, instrumental vaginal delivery and previous perineal surgeries .There are four types of episiotomy: midline, mediolateral, lateral and J shaped. Care of episiotomy involves perineal care, sitz bath, infrared heat, perineal exercises, antiseptic ointments, cold and hot packs The REEDA scale is used for assessing the perineal healing. Complications of episiotomy include perineal discomfort, perineal pain, difculty with breast feeding and walking, perineal bleeding, infection, wound dehiscence and dyspareunia.

Development of a web-based “Perineal Care Protocol” educational model as assistance for postpartum perineal wound care at home

Development of a web-based “Perineal Care Protocol” educational model as assistance for postpartum perineal wound care at home

Negative pressure wound therapy for perineal wound dehiscence extending to the vagina after Miles’ operation: a case report

Negative pressure wound therapy for perineal wound dehiscence extending to the vagina after Miles’ operation: a case report

Kersen leaf extract gel (Muntingia calabura L.) to Improve the healing of perineal wounds in postpartum mothers

Background: Delivery processes experience 90% perineal rupture—worldwide. Previous research on test animals proved the effect of cherry leaf gel on wound healing can kill microorganisms, increase collagen, and repair wound tissue. However, no research has been found on healing perineal wounds in postpartum mothers using cherry leaf gel, so this research is necessary.Purpose: Making and testing kersen leaf extract gel to improve perineal wound healing for postpartum women.Method: This is a quasi-experiment with a pre-post-test with a control group design. The sample consisted of 26 postpartum women with perineal injuries grade 2, divided into two groups (Intervention and control). The intervention was given a combination of kersen leaf gel 25% with antibiotic 2x1 for seven days, and the control group was only given the antibiotic. Perineal wound healing was assessed using the REEDA score. The data analysis used the Mann-Whitney test.Results: The results showed that the average REEDA score was lower in the intervention group than in the control group on day 3 (5.00±1.155 vs. 5.85±0.801; p=0.038), day 5 (2.31±0.650 vs. 3.23±1.013; p=0.029), and day 7 (0.23±0.439 vs. 1.15±0.987; p=0.039).Conclusion: Kersen leaf extract gel is effective in improving perineal wound healing in postpartum women.

STUDI KASUS: PENTINGNYA ASUHAN KEBIDANAN KOMPREHENSIF UNTUK MENCEGAH NYERI DAN INFEKSI PERINEUM PADA IBU POSTPARTUM

Perineal rupture is a tear that occurs in the perineum during labour. Perineal rupture occurs in almost all first deliveries and is not uncommon in subsequent deliveries. The occurrence of perineal rupture is caused by maternal factors (parity, birth spacing and baby's weight), improper delivery leadership, history of delivery. Forceps extraction, vacuum extraction, device trauma and episiotomy. Perineal rupture occurs in almost all first deliveries and is not uncommon in subsequent deliveries. This case study describes how perineal rupture occurs and its healing process in Mrs. M, a 21 year old primipara. Efforts to handle or treat perineal wounds in this case are carried out by teaching how to do proper wound care, maintaining personal hygiene and providing education to increase client knowledge. Midwifery care provided can help clients accelerate the healing of perineal wounds. Comprehensive midwifery care regarding postpartum care needs to be carried out from the time of pregnancy until later in the puerperium. Thus, the client can prevent and deal with problems that occur independently so that there are no infections or complications during the puerperium.

EFEKTIVITAS PENGGUNAAN LIDAH BUAYA (ALOEVERA) TERHADAP PENYEMBUHAN LUKA PERINEUM PADA IBU NIFAS DIWILAYAH KERJA PUSKEMAS KARANG ANYAR LAMPUNG SELATAN TAHUN 2021

Perineal rupture is one of the causes of postpartum maternal bleeding. Postpartum hemorrhage is themain cause of 40% of maternal deaths in Indonesia. One way of natural treatment is by giving aloe vera whichcan accelerate the wound healing process. The purpose of this study was to determine the effectiveness of theuse of aloe vera (Aloevera) on the healing of perineal wounds in postpartum mothers in the Karang Anyar HealthCenter, South Lampung.The Study employed a quantitative research with quasi-experimental approach. The subjects of thisstudy were mothers who experienced perineal rupture of degree I and degree II in the Work Area of the KarangAnyar Health Center, South Lampung, 104 mothers, a sample of 51 data. Data obtained from questionnaires.Analysis using univariate and bivariate analysis using independent t test.The results of this study found that the average value of perineal wound healing given aloe vera(aloevera) was 4.72, standard deviation 1.815. The average value of perineal wound healing that was not givenaloe vera was 7.35, the deviation was 2.545. There is an effectiveness of using aloe vera (Aloevera) on thehealing of perineal wounds in postpartum mothers in the Karang Anyar Health Center, South Lampung(Pvalue=0.026,).Kesimpulan dalam penelitian ini Terdapat efektivitas penggunaan lidah buaya (Aloevera)terhadap penyembuhan luka perineum pada ibu nifas di Wilayah Kerja Puskesmas Karang Anyar LampungSelatan saran penelitian ibu yang mengalami luka perineum untuk merawat luka setalah melahirkan danmengkonsumsi makanan bergizi khususnya makananan yang mengandung protein tinggi agar lukanya cepatsembuh.From the results of the study, researchers suggest mothers who experience perineal wounds to treatwounds after childbirth and consume nutritious foods, especially foods that contain high protein in order toaccelerate the wound healing process

A Study to Assess the Knowledge and Perineal Self-Care Practices on Episiotomy Wound Among Primiparous Women

The female perineum becomes suffused and stretched during pregnancy, and further strain during vaginalchildbirth contributes to approximately 85% of women experiencing some degree of trauma to the perinealregion. Multiple factors play a role in the type and severity of trauma experienced, including parity, deliverymethod, and local practices.There is ongoing debate about best midwifery practice to reduce perineal trauma.Once perineal trauma has occurred,treatment also varies greatly, depending on its degree and severity, localpractice and customs, and personal preference. .In order to optimise wound-healing outcomes, it is important thatwounds are assessed and managed in an appropriate and timely manner. During pregnancy and primiparousperiod nurses educate mothers about health behaviour that enhance positive outcomes particularly thoserelated to self-care. The proper and effective care is thus required to prevent from the morbidity and for enjoyingmotherhood. A perineal wound may cause significant physical and/or psychological impact in the short or longterm, however little evidence is available on this subject.

The Effect of Giving Boiled Chicken Eggs on the Healing of Perineal Wounds for Postpartum Mothers in the Independent Practice of Midwife Sumiariani in 2021

Postpartum infections still play a role as the main cause of maternal death, especially in developing countries like Indonesia. The aim of this study was to determine the effect of giving boiled chicken eggs on perineal wound healing in postpartum women. The type of research used in this study was a Quasi Experiment with a population of postpartum women with perineal wounds with a total sample of 10 respondents, 5 respondents (intervention group) and 5 respondents (control group). The results of the study showed that the average length of days healing of perineal wounds in postpartum women in the intervention group (given boiled eggs) was 5.4 days. The mean duration of perineal wound healing in the control group was 10.6 days. There is an effect of giving boiled chicken eggs on perineal wound healing in postpartum women with a p-value of 0.000 &lt;0.05.

Differences in the Healing of Perineal Wounds in Postpartum Mothers and Hecting Using the Dotted Technique and the Basting Technique

Many factors influence the healing of perineal wounds such as internal, external to the mother and factors from health workers. Healing efforts can be carried out by non-pharmacological methods, namely Kegel exercises, mobilization, herbal concoctions. Healing perineal wounds from the perspective of health workers such as suturing techniques. There are several techniques for sewing perineal wounds, such as interrupted, continuous, subticular. The purpose of this study was to see differences in the healing of perineal wounds in postpartum mothers using the interrupted technique and the subticular technique at the T and BPM D Clinics in Deli Serdang Regency in 2020. The design of this study was an experiment with a longitudinal time approach. Sample: All postpartum women who experienced perineal injuries at the Second Grade clinic at T and BPM D Clinics were 20 people. Results: The average perineal wound healing using the basting technique was faster healing (15.20) than the dotted technique (17.40) . The results of the bivariate analysis stated that there was no significant difference between the healing time of the perineal hecting wound with the dotted technique and basting with a value of p = 0.271 (&gt; 0.005). Health workers should improve their ability to handle episiotomy wounds so that they heal quickly and do not get infected

EFEKTIVITAS REBUSAN DAUN SIRIH HIJAU TERHADAP PENYEMBUHAN LUKA PERINEUM PADA IBU NIFAS DI DESA MOJONGAPIT JOMBANG

Cases of infection during the puerperium are caused by infections that are localized in the birth canal and the most common cause, more than 50%, are anaerobic Streptococcus bacteria which are actually not pathogenic. Green betel leaves are known to have antiseptic and antibacterial properties. The research method is quasi-experimental, the population taken in this study was postpartum mothers who were in the village of Mojongapit, Jombang district, with a total of 24 respondents. The technique used in sampling is purposive sampling. The inclusion criteria for sampling were as follows: postpartum mothers who experienced second and third degree perineal injuries with physiological delivery, mothers who were willing to become respondents. Analysis using the Mann - Whitney Test. The results showed that the healing time for perineal wounds in postpartum mothers who were given boiled green betel leaves was 4 - 6 days. The length of time for perineal wound healing in postpartum women who were not given boiled green betel leaves was 5-9 days. Differences in the duration of perineal wound healing in postpartum women who were given green betel leaf decoction was 0.4 times faster than postpartum women who were not given green betel leaf decoction&#x0D;

Efektivitas Air Rebusan Biji Pinang Muda dan Asam Kandis terhadap Intensitas Nyeri dan Penyembuhan Luka Perineum pada Ibu Nifas

The perineal wound is a difficult area to keep clean and dry. Postpartum mothers with perineal wounds complain of pain in their sutures and difficulty in doing activities. Perineal wound care is important to accelerate wound healing, avoid infection, and repair tissue. This study aimed to determine the effectiveness of decoction water of young areca nut and Kandis acid on pain intensity and perineal wound healing in postpartum mothers. This study used a quasi-experiment with a pre-post test with a control group design approach with a sample of 22 postpartum mothers consisting of 11 people intervention group and 11 people control group which are selected by accidental sampling. The measuring instruments were using the NRS pain scale and the Southampton scale and the Bates-Jensen Wound Continuity Scoring. The statistical analysis of the study using the Kruskal-Wallis test on the pain variable obtained p-value=0.000 (p-value&lt;0.05), and the Wilcoxon test on the wound healing variable obtained p-value=0.003 (p-value&lt;0.05). The results of the Mann-Whitney statistical test showed a significant difference between the intervention group and control group with p-value=0.000. The results of this study showed that therapy using decoction water of young areca nut and Kandis acid for 4 days was effective in pain relief and accelerating perineal wound healing in postpartum mothers. The information on perineal care using decoction water of young areca nut and Kandis acid can be used to help accelerate wound healing and pain relief, and prevent infection in postpartum mothers with a perineal wound.

Studies of the Effect of Hypnoanasthesia in Reducing Perineal Laceration Suture Pain And Healing of Postpartum Perineal Wounds in Indonesia

Pervaginal childbirth until now is still the choice of the method of childbirth that is considered the safest and economical. Although the delivery assistance has been done correctly, most women will experience perineal trauma during the vaginal labor process and require perineal suturing. The problem that is often faced by a mother who has a perineal tear is pain during the suturing process and will last until the suture wound is dry and the duration of the healing process of the perineal suture wound. This type of research is quantitative analytics using a Quasi-Experimental research design with the one-group post-test design method. Free variables: Hypnoanasthetic method and bound variables: the pain of perineal suture wounds and healing of perineal wounds. The sample in this study was 66 maternity mothers using purposive sampling techniques. Instruments: Checklists and Observation sheets, data analysis using the Wilcoxon Test. The results showed that after being given the hypnoanastesi method, almost all respondents experienced mild pain during suturing perineal lacerations, namely 87.9% and most respondents took a fast time (2 weeks) in healing perineal wounds, namely 23 respondents (69.7%). This study concludes that the hypnoanastesi method is effective in reducing the pain of suturing perineal lacerations and is effective in the healing process of perineal wounds.

EFEKTIVITAS PEMBERIAN TELUR REBUS TERHADAP PENYEMBUHAN LUKA PERINEUM PADA IBU NIFAS

Tanjung Gadang Health Center is one of the health centers in Sijunjung Regency which reported 128 cases of normal deliveries with perineal injuries. Mothers giving birth normally in 2021. And these cases were dominated by degree 2 perineal rupture at Tanjung Gadang Health Center in 2021. The purpose of the study was to to determine the effectiveness of giving boiled eggs on perineal wound healing in postpartum women . This research is quantitative with Quasi Experimental type with post test only non equivalent control group design . The population in this study were all postpartum mothers in the Tanjung Gadang Health Center, Sijunjung Regency as many as 30 postpartum mothers. The research was conducted in Januari 2022. The sample of this study was 30 people who were divided into 2 experimental groups. Sampling with total sampling, data were analyzed by Univariate and Bivariate. The results of the univariate analysis showed that the average wound healing score (REEDA Scale) in the group given one boiled egg a day after 7 days was 5.42 said to be slow and in the group giving two boiled eggs a day after 7 days was 3.84 it was said to be fast. The results of the bivariate analysis showed the effectiveness of giving boiled eggs on perineal wound healing in postpartum women (P value = 0.013). So, Wound healing was better in the intervention group of 2 boiled eggs/day . It is hoped that postpartum mothers will increase their knowledge and apply the consumption of boiled eggs to accelerate the healing of perineal wounds in postpartum women . &lt;br /&gt;Keywords : Postpartum Mother, Perineal Wound, Boiled Egg