The effects of flaxseed ointment on cesarean wound healing: randomized clinical trial

Document Type : Original Article

Authors

1 M.Sc. Student in midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Instructor, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Assistant Professor, Department of Pharmaceutical Sciences in Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

5 Instructor, Department of Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: In cesarean section incision, like as any other surgery, there is possibility of delay in wound healing. According to studies, flaxseed oil is effective in wound healing. This study was performed with aim to determine the effects of flaxseed oil on cesarean wound healing.
Methods: This three-blind randomized clinical trial was performed on 120 women with cesarean section at educational hospitals of Imam Reza and Shahid Hasheminejad of Mashhad in 2018. Individuals were randomly assigned to three groups (flaxseed ointment, placebo, control). In two groups of flaxseed ointment and placebo, the ointment was applied on cesarean section wound for 8 consecutive days and twice a day, each time as one finger strap. Wound healing was measured 24 hours after surgery, 4th and 8th day after cesarean section by REEDA Scale. Data were analyzed using SPSS software (version 25), and Chi-Square and Kruskal-Wallis tests. P <0.05 was considered statistically significant.
Results: According to the results of statistical tests, there was statistically significant difference between flaxseed group with control and placebo groups in terms of cesarean section wound healing on days 4 and 8 after the intervention (P <0.001). In addition, in the intergroup comparison, Friedman test showed that in all three groups, the variation of REEDA scale in different days was significantly different (P <0.001).
Conclusion: Regarding the reduction of REEDA cesarean wound score after the intervention, flaxseed oil is recommended as a suitable drug for cesarean section wound healing in mothers.

Keywords


  1. Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe J. Williams obstetrics. 25th ed. New York: McGraw Hill; 2014. P. 661-72.
  2. Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe J. Williams obstetrics. 24th ed. Trans: Ghazi J, Ghotbi R. Tehran: Golban Nashr Co.; 2014.
  3. Buggy D. Can anaesthetic management influence surgical-wound healing? Lancet 2000; 356(9227):355-7.
  4. Campos AC, Groth AK, Branco AB. Assessment and nutritional aspects of wound healing. Curr Opin Clin Nutr Metab Care 2008; 11(3):281-8. 
  5. Fraser DM, Cooper MA, Nolte AG. Myles textbook for midwives, 14th ed. London: Churchill Livingstone; 2003. P. 581-8.
  6. Vermillion ST, Lamoutte C, Soper DE, Verdeja A. Wound infection after cesarean: effect of subcutaneous tissue thickness. Obstet Gynecol 2000; 95(6 Pt 1):923-6.
  7. Magann EF, Chauhan SP, Rodts-palenik S, Bufkin L, Martin JN, Morrison JC. Subcutaneous stitch closure versus subcutaneous drain to prevent wound disruption after cesarean delivery: a randomized clinical trial. Am J Obstet Gynecol 2002; 186(6):1119-23.
  8. Kores S, Vyavaharkar M, Akolekar R, Toke A, Ambiyye V. Comparison of closure of subcutaneous tissue versus non-closure in relation to wound disruption after abdominal hysterectomy in obese patients. J Postgrad Med 2000; 46(1):26-8.
  9. Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. William's obstetrics. 23rd ed. New York: McGraw-Hill; 2010. P. 661-72.
  10. Pudner R. Nursing the surgical patient. New York: Elsevier Health Sciences; 2005. P. 27-34, 41-50.
  11. Roseorough IM, Grevious MA, Lee RC. Prevention and treatment of excessive dermal scarring. J Natl Med Assoc 2004; 96(1):108-16.
  12. Roesken F, Uhl E, Curri SB, Menger MD, Messmer K. Acceleration of wound healing by topical drug delivery via liposomes. Langenbecks Arch Surg 2000; 385(1):42-9.
  13. Samadi S, Khadivzadeh T, Emami A, Moosavi NS, Tafaghodi M, Behnam HR. The effect of Hypericum perforatum on the wound healing and scar of cesarean. J Altern Complement Med 2010; 16(1):113-7.
  14. Shahrahmani H, Kariman N, Jannesari S, Ghalandari S, Asadi N. A systematic review on the type of treatment methods to reduce pain and improve wound healing in Iran. Iran J Obstet Gynecol Infertil 2016; 19(9):17-31. (Persian).
  15. Mostofizadeh S. Evaluation of the effect of silica Q10 tablet on cesarean incision in Primiparous patients. Arak: Arak University of Medical Sciences; 2015. (Persian).
  16. Bastami A, Davari Dehkordi N, Ziagham S. The effect of phenytoin cream on cesarean wound healing. Iran J Obstet Gynecol Infertil 2014; 17(103):14-20. (Persian).
  17. Aradmehr M, Azhari S, Ahmadi S, Azmoude E. The effect of chamomile cream on episiotomy pain in Primiparous women: a randomized clinical trial. J Caring Sci 2017; 6(1):19-28.
  18. Skórkowska‐Telichowska K, Żuk M, Kulma A, Bugajska‐Prusak A, Ratajczak K, Gąsiorowski K, et al. New dressing materials derived from transgenic flax products to treat long‐standing venous ulcers--a pilot study. Wound Repair Regen 2010; 18(2):168-79.
  19. Beroual K, Agabou A, Abdeldjelil MC, Boutaghane N, Haouam S, Hamdi-Pacha Y. Evaluation of crude flaxseed (Linum Usitatissimum L) oil in burn wound healing in New Zealand rabbits. Afr J Tradit Complement Altern Med 2017; 14(3):280-6.
  20. Popa VM, Gruia A, Raba D, Dumbrava D, Moldovan C, Bordean D, et al. Fatty acids composition and oil characteristics of linseed (Linum Usitatissimum L.) from Romania. J Agroaliment Proc Technol 2012; 18(2):136-40.
  21. Kaithwas G, Mukherjee A, Chaurasia AK, Majumdar D. Anti-inflammatory, analgesic and antipyretic activities of Linum Usitatissimum L. (flaxseed/linseed) fixed oil. Indian J Exp Biol 2011; 49(12):932-8.
  22. Hill PD. Psychometric properties of the REEDA. J Nurse Midwifery 1990; 35(3):162-5.
  23. Davidson N. REEDA evaluation postpartum healing. J Nurse Midwifery 1974; 19(2):6-8.
  24. Rafiee S, Nekouyian N, Hosseini S, Sarabandi F, Chavoshi-Nejad M, Mohsenikia M, et al. Effect of topical Linum usitatissimum on full thickness excisional skin wounds. Trauma Mon 2017; 22(6):e64930.
  25. Babajafari S, Akhlaghi M, Mazloomi SM, Ayaz M, Noorafshan A, Jafari P, et al. The effect of isolated soy protein adjunctive with flaxseed oil on markers of inflammation, oxidative stress, acute phase proteins, and wound healing of burn patients; a randomized clinical trial. Burns 2018; 44(1):140-9.
  26. Ebrahimi VK, Talebi MS, Naseri M. Anti-inflammation effect of alcoholic extract of Linum Usitatissimum L. in male rats. J Babol Univ Med Sci 2014; 16(4):50-6.
  27. Neukam K, De Spirt S, Stahl W, Bejot M, Maurette JM, Tronnier H, et al. Supplementation of flaxseed oil diminishes skin sensitivity and improves skin barrier function and condition. Skin Pharmacol Physiol 2011; 24(2):67-74.