The Effect of Topical Ointment of Propolis on Severity of Episiotomy Pain and Wound Healing: A Triple-Blinded Randomized Controlled Clinical Trial

Abstract

Abstract Introduction: Vaginal and perineal ruptures are among the most prevalent complications of childbirth, which may occur spontaneously during childbirth or through a surgical incision (episiotomy) in the vagina or perineum. Delayed episiotomy wound healing and its resultant pain can culminate in short-term and long-term maternal and neonatal complications. Therefore, the present study was conducted aiming to investigate the effect of propolis topical ointment on episiotomy pain severity (the primary consequence) and wound healing (the secondary consequence) and to determine the related complications. Methods: The present research was a triple-blinded randomized clinical trial conducted on 72 puerperal women, gravid 1 and 2 (36 women in the propolis ointment group and 36 women in the placebo group), referring to Taleghani Hospital, Tabriz, Iran, from April to December 2023. The intervention group received propolis ointment, and the control group received a placebo (Eucerin ointment) as much as a knuckle (2 cm) in the perineal area twice a day, 12 hours apart (±2 hours), for 10 days. The data were collected using a demographic and obstetric questionnaire, the Redness, Edema, Ecchymosis, Discharge, Approximation (REEDA) Scale, and the Visual Analogue Scale (VAS) by the researcher during the first 12 hours and on the 10±1 postpartum day. The data were analyzed using the Mann-Whitney U test because of the non-normal distribution of data.

Results: Means ± standard deviations (SDs) of the REEDA score in the propolis and placebo groups were 0.7±0.8 and 0.7±0.7 on the first postpartum day and 0.6±1.0 and 0.3±0.7 on the 10th postpartum day, respectively, indicating no statistically significant difference between the two groups before (p=0.912) and after (p=0.413) the intervention. Means ± SDs of the VAS score in the propolis and placebo groups were 3.7±2.3 and 3.3±1.6 on the first postpartum day and 2.4±2.1 and 2.0±1.3 on the 10th postpartum day, respectively, showing no statistically significant difference between the two groups before (p=0.568) and after (p=0.573) the intervention. Conclusion: According to the present study results, propolis ointment does not lead to increasing wound healing rate and relieving episiotomy pain. However, further research is recommended to confirm the study findings.