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- Lavender (Lavandula spp.)
- Povidone-iodine
- Episiotomy
| Date:
02-15-2011 | HC# 0111161-418
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Re: Lavender Essential Oil and Povidone-iodine Are Similarly Effective Treatments for Episiotomy Wound Healing
Vakilian
K, Atarha M, Bekhradi R, Chaman R. Healing advantages of lavender essential oil
during episiotomy recovery: a clinical trial. Complement Ther Clin Pract. Feb 2011;17(1):50-53.
doi:10.1016/j.ctcp.2010.05.006.
Episiotomy
is a perineal incision that is performed to prevent vaginal lacerations during
childbirth. Antiseptic sitz baths are routinely used in postpartum episiotomy
wound care, and povidone-iodine topical antiseptics are used in particular in Iran. Spanish
lavender (Lavandula stoechas) has a
long history of traditional medicinal use. Constituents of lavender (Lavandula spp.) essential oil have anti-inflammatory,
antifungal, and antibacterial effects, including activity against gram-negative
and gram-positive bacteria, as well as pathogenic fungi. Two clinical trials have
found that lavender oil added to bathwater reduces postpartum perineal
discomfort.1,2 The purpose of this randomized, controlled clinical
trial was to examine the effect of lavender (species not stated) essential oil
baths compared to povidone-iodine treatment on episiotomy wound healing.
The
study was conducted by researchers at Barij Essence Pharmaceutical Co. (Delijan, Iran),
Arak University of Medical Sciences (Tehran, Iran), and Shahrood University of Medical
Sciences (Shahrood, Iran). Lavender essential oil was
extracted from fresh flowers and inflorescences collected immediately before
blooming and diluted with olive oil to produce a 1.5% lavender essential oil
product. The researchers enrolled 120 subjects, including primiparous women
with singleton pregnancies who had received mediolateral episiotomies during
spontaneous vaginal deliveries. None of the subjects had allergies or chronic
diseases. The researchers used computerized block randomization to divide the
subjects into 2 groups: lavender oil (n=60) and control (n=60). The control
group received povidone-iodine antiseptic (exact treatment protocol not
discussed). The lavender oil group took sitz baths with 5-7 drops lavender
essential oil in 4 L of water twice daily for 10 days. On the tenth day after childbirth,
the subjects came to Taleghani clinic (location not stated) for an episiotomy
evaluation by a trained, blinded midwife. The evaluation included an assessment
of 6 criteria: pain (visual analogue scale), edema (cm), redness (mm), dehiscence
(wound opening), number of sutures, and infection. Retest (r=0.8) was used to
assess reliability.
The
authors did not discuss study withdrawals. There were no significant
differences between the groups in age, occupation, education, duration of the
first and second stages of labor, number of pregnancies, and newborn weight. At
10 days, there was no significant difference between the groups in pain, with
17 subjects in the control group and 25 subjects in the lavender oil group
reporting no pain (P=0.063). However, more subjects in the control group
reported severe pain compared to the lavender oil group (18 vs. 8,
respectively). None of the lavender oil subjects showed edema greater than 2 cm,
while 7 control group subjects did. There were also no significant differences
in edema, leaved suture, or dehiscence.
Redness
was significantly reduced in the lavender oil group compared to the control
group. After 10 days, 13 control group subjects and 31 lavender oil group subjects
had no redness (P=0.001), and 28 subjects in the control group and 8 subjects
in the lavender oil group showed redness greater than 7 mm (the greatest level
measured). The researchers report no complications, with the exception of
"a little irritation" in 2 subjects (treatment group not stated).
There were 5 subjects with mild infections treated by antibiotics (control:
n=2, lavender oil: n=3).
The
authors conclude that lavender essential oil is "a suitable therapy for
postpartum episiotomy wound care." The results show that subjects using lavender
oil sitz baths had a similar experience to those using povidone-iodine
antiseptics in treating postpartum episiotomy pain and edema and preventing
infection, though lavender oil was more effective in treating redness. The
authors suggest future clinical trials with larger subject samples and careful
follow-up to confirm these results.
—Marissa Oppel-Sutter, MS
References
1Dale A, Cornwell S.
The role of lavender oil in relieving perineal discomfort following childbirth:
a blind randomized clinical trial. J Adv
Nurs. Jan 1994;19(1):89-96.
2Cornwell S, Dale A.
Lavender oil and perineal repair. Mod
Midwife. Mar 1995;5(3):31-33.
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