عنوان مقاله [English]
Introduction: Episiotomy is a surgical incision of the perineum, which is done during delivery to facilitate and expedite delivery and to prevent perineal tears. Within the midwifery practice, perineal care both during and after the labor has changed during the past 20 years, however, there is little research on the care of this most frequently performed wound. Curcuma longa or turmeric is a tropical plant, which has the capability of healing wounds because of its containing curcuminoids. The aim of this study was to determine the effect of turmeric ointment on healing of episiotomy site in primiparous women.
Material and Methods: This study was a double blind clinical trial, which was accomplished in Omul Banin hospital affiliated to Mashhad University of Medical Sciences. Eighty four qualified primiparous women aged 17-35 years who were scheduled for normal vaginal delivery were recruited. Inclusion criteria were: Primiparity, gestational age 37-42 weeks, live and singleton pregnancy, and lack of chronic systemic diseases such as diabetes mellitus that can affect the healing process. The included women were alternately divided to the study and control groups. The turmeric ointment contained 5% ethanolic extract of turmeric rhizomes powder in Vaseline basement and placebo contained a few drops of in concentrated hydro alcoholic extract of turmeric rhizomes powder in Vaseline basement. Both the turmeric and placebo ointments were prepared, packed and coded in similar tubes by a pharmacologist who was blind to the study protocol. After delivery, in case of performing episiotomy, the women were advised to apply either the drug or the placebo every 12±2 hours for 10 days. The healing process was assessed at days 7th, 10th, and 14th after the delivery using the REEDA (Redness, Edema, Ecchymosis, Discharge, and Adhesive) scale. The data were analyzed using Student's t, c2, and Mann-Whitney tests.
Results: There was not a significant difference in demographic characteristics and other distracted variables between the two groups. Of the 84 recruited women, 17 were excluded. The remaining 63 women consisted of 32 cases and 31 controls. At the 7th day postpartum, the mean REEDA score was 2.84±1.68 for the study group and 4.35±1.45 for the control group (P<0.001). At the 10th day, the mean REEDA score for the women in the study group was about half of their counterparts in the control group (2.09±1.594 v 4.10±1.777, P<0.001). At the 14th day, 4 days after discontinuing the treatment, the mean REEDA score for the study group was still lower than that of the control group (P=0.012). No side effect was seen or reported during the study.
Conclusion: The mean REEDA score for the study group at the 10th day was likely the control group at the 14th day. In fact, the turmeric ointment enhances the healing at the episiotomy site and decreases the duration of healing from 14 days to10 days. Therefore, it seems that this ointment can be prescribed for primiparous women with episiotomy incisions.