Application of dry heat promotes 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.
Moist heat is one of the techniques that can alleviate perineal pain and enhance wound healing. It requires immersion of the perineal area and buttocks for 15 to 20 minutes in warm water at a temperature of 110°–115°F. It can be used to lessen perineal discomfort, itching, or muscle spasms. Moist heat can also facilitate wound healing by soaking the perineum and anus, improving circulation, decreasing edema, and inflammation, and promoting muscle relaxation this study was carried out to compare the effects of dry heat versus moist heat application in reducing perineal pain and promoting episiotomy wound healing among primiparous women. The purpose of the study by Naglaa Zaki Hassan Roma et al 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. Authors 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 (P < 0.001 for the dry heat group and P = 0.004 for the moist heat group).
On investigating the perineal pain level, the results of the present study revealed that the pain was significantly reduced in the dry heat group than in the moist heat group on the 5th and 10th days after the interventions. The pain reduction could be attributed to the fact that heat application induces vasodilatation and increases blood circulation to the area. This could enhance tissue oxygenation, reduce muscle spasms, accelerate waste product removal, reduce inflammation, and promote episiotomy wound healing. Moreover, the heat application had soothing effects on the superficial sensory nerve endings.
Application of the Primipara women of dry heat promotes episiotomy wound healing and reduces their perineal pain during early postpartum days than moist heat. According to the present study’s findings, it is advised that dry heat be included in the postnatal units’ protocol as a useful nonpharmacological intervention to promote episiotomy wound healing and lessen perineal pain during the postpartum period.
Source: Naglaa Zaki Hassan Roma, Rasha Mohamed Essa, Zohour Ibrahim Rashwan; Hindawi Obstetrics and Gynecology International Volume 2023, Article ID 9572354 https://doi.org/10.1155/2023/9572354
