Abstract
Background: Episiotomy is one of the most common surgical procedures in the world that is associated with perineal pain and can be exposed to infection, or might be healed with delay.
Objective: The aim of this study was to investigate the effects of honey-olive oil combination on episiotomy wound healing and pain relief in primiparous women. Methods: This single-blind, parallel randomized clinical trial (IRCT20120215009014N208) was conducted on 80 primiparous women. They were allocated randomly to each of the groups through random allocation rule: 40 in honey-olive oil group and 40 in the control group. Every 12 hours and for 14 days, the treatment group used about 1 inch of the cream on the wound area. Pain intensity and wound healing were measured by REEDA Scale and Visual Analogue Scale on days 7, 10, and 14 in both groups. The statistical analyst was not informed about the allocation of the groups. A significant level of 0.05 was considered. Results: There was a significant difference between healing score and pain intensity between the two groups on 7th, 10th and 14th postpartum days (p <0.05). Wound healing occurred much faster (Scores on days 7,10, and 14 were 11.25±2.13, 7.47±1.96 and 4.95±1.53 in the control group and 4.45±1.25, 2.32±.69 and 10±.30 in the intervention group, p <0.05). Moreover, pain intensity was significantly relieved in those who used Honey and olive oil cream (the scores were 5.6750±1.43, 3.3500±1.52, 2.2250±1.34 in the control group and 1.9750±1.52, .2250±.57, .0250±.15 in the intervention group, P<0.05). Conclusion: Using honey and olive oil combination improves episiotomy wound healing and also relieves its’ associated pain.Keywords: Episiotomy, wound healing, honey, olive oil, pain, cream.
Graphical Abstract
[1]
Cunningham FG, Leveno KJ, Bloom SL, et al. Williams Obstetrics. 25th ed. New york: McGraw-Hill Education 2018; Vol. 1.
[2]
Simbar M, Lavvaf M, Mojab F, Majd HA, Samimi M. Comparison of honey cream and phenytoin cream effects on episiotomy wound healing in nulliparous women. CMJA 2015; 5(1): 1091-104.
[3]
Vakilian k, Atarha M, Bekhradi R, Ghebleh F, Hatami Z, Ceraj A. The effect of lavender in care of postpartum episiotomy wounds. JSKUMS 2008; 10: 63-9.
[4]
Behnammoghadam M, Paymard A, Salehian T, et al. The effect of local olive oil on prevention of pressure ulcers in patients hospitalized in the intensive care unit of Shahid Beheshti Hospital, Yasuj: A double-blind randomized clinical trial. JAP 2017; 7(4): 54-61.
[5]
Israili ZH. Antimicrobial properties of honey. Am J Ther 2014; 21(4): 304-23.
[http://dx.doi.org/10.1097/MJT.0b013e318293b09b] [PMID: 23782759]
[http://dx.doi.org/10.1097/MJT.0b013e318293b09b] [PMID: 23782759]
[6]
Martinotti S, Bucekova M, Majtan J, Ranzato E. Honey: an effective regenerative medicine product in wound management. Curr Med Chem 2019; 26(27): 5230-40.
[http://dx.doi.org/10.2174/0929867325666180510141824] [PMID: 29745320]
[http://dx.doi.org/10.2174/0929867325666180510141824] [PMID: 29745320]
[7]
Martinotti S, Ranzato E. Honey, wound repair and regenerative medicine. J Funct Biomater 2018; 9(2): E34
[http://dx.doi.org/10.3390/jfb9020034] [PMID: 29738478]
[http://dx.doi.org/10.3390/jfb9020034] [PMID: 29738478]
[8]
Oryan A, Alemzadeh E, Moshiri A. Biological properties and therapeutic activities of honey in wound healing: A narrative review and meta-analysis. J Tissue Viability 2016; 25(2): 98-118.
[http://dx.doi.org/10.1016/j.jtv.2015.12.002] [PMID: 26852154]
[http://dx.doi.org/10.1016/j.jtv.2015.12.002] [PMID: 26852154]
[9]
Yousefi Z, Rezaeigolestani M, Hashemi M. Biological properties of olive oil. J Hum Environ Health Promot 2018; 4(2): 50-4.
[http://dx.doi.org/10.29252/jhehp.4.2.2]
[http://dx.doi.org/10.29252/jhehp.4.2.2]
[10]
Vogel P, Kasper Machado I, Garavaglia J, Zani VT, de Souza D, Morelo Dal Bosco S. Polyphenols benefits of olive leaf (Olea europaea L) to human health. Nutr Hosp 2014; 31(3): 1427-33.
[PMID: 25726243]
[PMID: 25726243]
[11]
Covas MI, de la Torre R, Fitó M. Virgin olive oil: a key food for cardiovascular risk protection. Br J Nutr 2015; 113(S2)(Suppl. 2): S19-28.
[http://dx.doi.org/10.1017/S0007114515000136] [PMID: 26148918]
[http://dx.doi.org/10.1017/S0007114515000136] [PMID: 26148918]
[12]
Ghanbari R, Anwar F, Alkharfy KM, Gilani AH, Saari N. Valuable nutrients and functional bioactives in different parts of olive (Olea europaea L.)-a review. Int J Mol Sci 2012; 13(3): 3291-340.
[http://dx.doi.org/10.3390/ijms13033291] [PMID: 22489153]
[http://dx.doi.org/10.3390/ijms13033291] [PMID: 22489153]
[13]
Azhari S, Aradmehr M, Rakhshandeh H, Tara F, Shakeri M. The effects of chamomile cream on wound healing of episiotomy in primiparous women. Iranian J Obstet Gynecol Infertil 2014; 17(93): 16-26.
[14]
Lavaf M, Simbar M, Mojab F. Comparison of honey and phenytoin
(PHT) cream effects on intensity of pain and episiotomy wound
healing in nulliparous women. J Complement Integr Med 2018; 15(1) pii: /j/jcim.2018.15.issue-1/jcim-2016-0139/jcim-2016-0139
[15]
Davidson N. REEDA: evaluating postpartum healing. J Nurse Midwifery 1974; 19(2): 6-8.
[PMID: 17338109]
[PMID: 17338109]
[16]
Pore Y. Effectiveness of moist heat and dry heat application on healing of episiotomy wound. AJMS 2014; 2(7): 225-36.
[17]
Heidari T, Roozbahani N, Farahani L, et al. Does Iranian Astragalus gossypinus honey assist in healing caesarean wounds and scars? Eur J Integr Med 2013; 5(3): 226-33.
[http://dx.doi.org/10.1016/j.eujim.2013.01.005]
[http://dx.doi.org/10.1016/j.eujim.2013.01.005]
[18]
Al-Waili NS. Topical application of natural honey, beeswax and olive oil mixture for atopic dermatitis or psoriasis: partially controlled, single-blinded study. Complement Ther Med 2003; 11(4): 226-34.
[http://dx.doi.org/10.1016/S0965-2299(03)00120-1] [PMID: 15022655]
[http://dx.doi.org/10.1016/S0965-2299(03)00120-1] [PMID: 15022655]
[19]
Al-Waili NS. Clinical and mycological benefits of topical application of honey, olive oil and beeswax in diaper dermatitis. Clin Microbiol Infect 2005; 11(2): 160-3.
[http://dx.doi.org/10.1111/j.1469-0691.2004.01013.x] [PMID: 15679495]
[http://dx.doi.org/10.1111/j.1469-0691.2004.01013.x] [PMID: 15679495]
[20]
Rashidi M, Mirazi N, Hosseini A. Effect of topical mixture of honey, royal jelly and olive oil-propolis extract on skin wound healing in diabetic rats. Wound Med 2016; 12: 6-9.
[http://dx.doi.org/10.1016/j.wndm.2015.12.001]
[http://dx.doi.org/10.1016/j.wndm.2015.12.001]
[21]
Vardi A, Barzilay Z, Linder N, Cohen HA, Paret G, Barzilai A. Local application of honey for treatment of neonatal postoperative wound infection. Acta Paediatr 1998; 87(4): 429-32.
[http://dx.doi.org/10.1111/j.1651-2227.1998.tb01473.x] [PMID: 9628301]
[http://dx.doi.org/10.1111/j.1651-2227.1998.tb01473.x] [PMID: 9628301]
[22]
Jull AB, Cullum N, Dumville JC, Westby MJ, Deshpande S, Walker N. Honey as a topical treatment for wounds. Cochrane Database Syst Rev 2015; (3): CD005083
[http://dx.doi.org/10.1002/14651858.CD005083.pub4] [PMID: 25742878]
[http://dx.doi.org/10.1002/14651858.CD005083.pub4] [PMID: 25742878]
[23]
Henriques A, Jackson S, Cooper R, Burton N. Free radical production and quenching in honeys with wound healing potential. J Antimicrob Chemother 2006; 58(4): 773-7.
[http://dx.doi.org/10.1093/jac/dkl336] [PMID: 16963460]
[http://dx.doi.org/10.1093/jac/dkl336] [PMID: 16963460]
[24]
Eteraf-Oskouei T, Najafi M. Traditional and modern uses of natural honey in human diseases: a review. Iran J Basic Med Sci 2013; 16(6): 731-42.
[PMID: 23997898]
[PMID: 23997898]
[25]
Tonks A, Cooper RA, Price AJ, Molan PC, Jones KP. Stimulation of TNF- release in monocytes by honey. Cytokine 2001; 14(4): 240-2.
[http://dx.doi.org/10.1006/cyto.2001.0868] [PMID: 11448125]
[http://dx.doi.org/10.1006/cyto.2001.0868] [PMID: 11448125]
[26]
Amani R, Kariman N, Mojab F, Alavi Majd H, Majidi S. Comparison of the effects of cold compress with gel packs and topical olive oil on episiotomy wound healing. J Babol Univ Med Sci 2015; 17(11): 7-12.
[27]
Behmanesh F, Aghamohammadi A, Zeinalzadeh M, Khafri S. Effects of olive oil sitz bath on improvement of perineal injury after delivery. Koomesh 2013; 14(3): 309-15.
[28]
Mashhood AA, Khan TA, Sami AN. Honey compared with 1% silver sulfadiazine cream in the treatment of superficial and partial thickness burns. J Pak Assoc Dermatol 2006; 16: 14-9.
[29]
Ozlugedik S, Genc S, Unal A, Elhan AH, Tezer M, Titiz A. Can postoperative pains following tonsillectomy be relieved by honey? A prospective, randomized, placebo controlled preliminary study. Int J Pediatr Otorhinolaryngol 2006; 70(11): 1929-34.
[http://dx.doi.org/10.1016/j.ijporl.2006.07.001] [PMID: 16914210]
[http://dx.doi.org/10.1016/j.ijporl.2006.07.001] [PMID: 16914210]
[30]
Yaghoobi R, Kazerouni A, Kazerouni O. kazerouni O. Evidence for clinical use of honey in wound healing as an anti-bacterial, anti-inflammatory anti-oxidant and anti-viral agent: A review. Jundishapur J Nat Pharm Prod 2013; 8(3): 100-4.
[http://dx.doi.org/10.17795/jjnpp-9487] [PMID: 24624197]
[http://dx.doi.org/10.17795/jjnpp-9487] [PMID: 24624197]
[31]
Lusby PE, Coombes AL, Wilkinson JM. Bactericidal activity of different honeys against pathogenic bacteria. Arch Med Res 2005; 36(5): 464-7.
[http://dx.doi.org/10.1016/j.arcmed.2005.03.038] [PMID: 16099322]
[http://dx.doi.org/10.1016/j.arcmed.2005.03.038] [PMID: 16099322]
[32]
Oluwatosin OM, Olabanji JK, Oluwatosin OA, Tijani LA, Onyechi HU. A comparison of topical honey and phenytoin in the treatment of chronic leg ulcers. Afr J Med Med Sci 2000; 29(1): 31-4.
[PMID: 11379464]
[PMID: 11379464]
[33]
Ahmed AK, Hoekstra MJ, Hage JJ, Karim RB. Honey-medicated dressing: transformation of an ancient remedy into modern therapy. Ann Plast Surg 2003; 50(2): 143-7.
[http://dx.doi.org/10.1097/01.SAP.0000032306.44107.C1] [PMID: 12567050]
[http://dx.doi.org/10.1097/01.SAP.0000032306.44107.C1] [PMID: 12567050]
[34]
Servili M, Sordini B, Esposto S, et al. Biological activities of phenolic compounds of extra virgin olive oil. Antioxidants 2013; 3(1): 1-23.
[http://dx.doi.org/10.3390/antiox3010001] [PMID: 26784660]
[http://dx.doi.org/10.3390/antiox3010001] [PMID: 26784660]