The Effect of Equisetum Arvense (horse tail) Ointment on Wound Healing and Pain Intensity after Episiotomy: A Randomized Placebo- Controlled trial

Abstract

Abstract: Background: Episiotomy, a common surgical practice in midwifery, is accompanied with high levels of pain and discomfort for the mothers. The importance of medicinal herbs and traditional medicine in wound healing cannot be neglected. Considering the positive effects and easy accessibility of Equisetum ravens, this study examined the effectiveness of the topical application of Equisetum ravens ointment in wound healing, reduction of inflammation, and pain relief after episiotomy in nulliparous mothers. Methods and material: this double-blind clinical trial was performed on 108 postpartum nulliparous mothers (54 woman in horse tail group and 54 woman in placebo group) in Al-Ahram educational-medical center (Tabriz, Iran). About 5± 1 and 10± 1 days after the childbirth, the primary outcomes of episiotomy, i.e. wound healing and pain intensity, were assessed based on the redness, edema, ecchymosis, discharge, and approximation of the edges (REEDA) scale and a visual analogue scale (VAS), respectively. The secondary outcomes evaluated in the current research were the number of used painkillers and the adverse daring the 10-period of the study. The data were analyzed using independent and Mnn-whitney U, ANCOVA, X2 tests. Results: the case and control had no significant differences in terms of the mean wound healing score (5.0± 1.6 vs. 4.5± 1.6) and mean pain intensity (5.7±2.4 vs. 5.3±2.2) at baseline, doting both follow up sessions (5±1 and 10± 1days after delivery,) the mean scores were significantly lower in the case group that in the control group. The adjusted pain score difference (MD) after 5± 1 and 10± 1 Day was -2.3(95% ci:-32 to -1.3) and 3.8 (95% CI:-4.7 to -3.0), respectively the mean number of acetaminophen pills used in the control and groups during the 10- day period the mean numbers of acetaminophen pills used in the control and groups during the 10-day period of the study were 6.8± 4.4 and 11.6± 7.1, respectively (p<0.001). Conclusion: according to our findings, the 3% equisetum ravens ointment promoted wound healing and relieved pain during the 10-day period after episiotomy. Since this study was the first to assess the effects of Equisetum ravens ointment on wound healing and pain intensity following episiotomy in humans, further research is warranted to fully clarify the beneficial effects of the prepared ointment.