Effectiveness of honey-lidocaine and honey-povidone iodine combination cream therapy in healing second-degree perineal rupture wounds
Keywords:
perineal rupture, wound healing, honeyAbstract
Background: Second-degree perineal rupture involves vaginal mucosa and perineal muscle injury, influenced by factors like primiparity, macrosomia, and prolonged labor. Wound healing follows stages of hemostasis, inflammation, proliferation, and remodeling. To accelerate the wound healing, honey has been used as an alternative due to its antimicrobial, anti-inflammatory, and antioxidant properties. This study evaluates the effectiveness of honey-lidocaine and honey-povidone iodine combinations in healing perineal wound.
Methods: A double-blind RCT was conducted at Siti Khadijah 1 Hospital (Feb–Aug 2024), involving postpartum women with second-degree perineal rupture. Participants applied one of three creams twice a day for 14 days. Healing was assessed using the REEDA scale on days 0, 1, 7, and 14. The data were analyzed using ANOVA, Kruskal-Wallis, Mann-Whitney, paired T-tests, and Wilcoxon tests (p < 0.05).
Results: Most participants with normal BMI were nulliparous, aged 20–35. By day 7, REEDA scores were significantly lower (p < 0.001) in the honey-lidocaine group. The best healing was observed by day 14.
Conclusions: Honey-lidocaine cream demonstrates faster healing than honey-povidone iodine and placebo, offering a promising postpartum wound care option
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Macedo MD, Risløkken J, Halle T, et al. Occurrence and risk factors for second-degree perineal tears: A prospective cohort study using a detailed classification system. Birth 2024;51:602–11. https://doi.org/10.1111/birt.12817.
Puissegur A, Accoceberry M, Rouzaire M, et al. Risk factors for perineal wound breakdown in early postpartum: A retrospective case–control study. J Clin Med 2023;12:10–7. https://doi.org/10.3390/jcm12083036.
Tottoli EM, Dorati R, Genta I, et al. Skin wound healing process and new emerging technologies for skin wound care and regeneration. Pharmaceutics 2020;12:735. https://doi.org/10.3390/pharmaceutics12080735.
Rodrigues M, Kosaric N, Bonham C, Gurtner G. Wound healing: A cellular perspective. Physiol Rev 2019;99:665–06. https://doi.org/10.1152/physrev.00067.2017.
Maheswary T, Nurul AA, Fauzi MB. The Insights of microbes’ roles in wound healing: A comprehensive review. Pharmaceutics 2021;13:981. https://doi.org/10.3390/pharmaceutics13070981.
Dehkordi AN, Babaheydari FM, Chehelgerdi M, Dehkordi SR. Skin tissue engineering: Wound healing based on stem-cell-based therapeutic strategies. Stem Cell Res Ther 2019;10:111. https://doi.org/10.1186/s13287-019-1212-2.
Tashkandi H. Honey in wound healing: An updated review. Open Life Sci 2021;16:1091–100. https://doi.org/10.1515/biol-2021-0084.
Silva B, Biluca FC, Gonzaga LV, et al. In vitro anti-inflammatory properties of honey flavonoids: A review. Food Res Int 2021;141:110086. https://doi.org/10.1016/j.foodres.2020.110086.
Harun H, Haroen H, Mirwanti R, et al. Uncovering the benefits of povidone iodine compared to other therapeutic agents in wound infection prevention and healing outcomes: A scoping review. J Multidiscip Healthc 2024;17:3605–16. https://doi.org/10.2147/JMDH.S469037.
Shekho HA, Wadee SA, Al-Bayati HHK, Ismaeal MA. Evaluation the effect and efficacy of lidocaine on healing of skin wound in rabbits. Syst Rev Pharm 2020;11:1368–72. https://doi.org/10.31838/srp.2020.12.203.
Akhtari N, Ahmadi M, Kiani Doust VY, et al. Natural agents as wound-healing promoters. Inflammopharmacology 2024;32:101–25. https://doi.org/10.1007/s10787-023-01318-6.
Simarmata M. Differences in the healing of perineal wounds in postpartum mothers and hecting using the dotted technique and the basting technique. Sci Midwifery 2022;10:4219–24. https://doi.org/10.35335/midwifery.v10i5.953.
Magoga G, Saccone G, Al-Kouatly HB, et al. Warm perineal compresses during the second stage of labor for reducing perineal trauma: A meta-analysis. Eur J Obstet Gyn R B 2019;240:93–8. https://doi.org/10.1016/j.ejogrb.2019.06.011.
Djusad S, Purwosunu Y, Hidayat F. Relationship between perineal body length and degree of perineal tears in primigravidas undergoing vaginal delivery with episiotomy. Obstet Gyn Int 2021:1–5. https://doi.org/10.1155/2021/2621872.
dos Santos RV, Pereira ARR, Lima CRO de P, et al. Perineal trauma in nulliparous women and its associated factors. ABCS Health Sci 2021;38:47–51. https://doi.org/10.7322/abcshs.2020047.1496.
Tashkandi H. Honey in wound healing: An updated review. Open Life Sci 2021;16:1091–100. https://doi.org/10.1515/biol-2021-0084.
Mulyaningsih S, Dunggio R, Susanti KA. The Effect of pineapple juice and honey on the acceleration of perineal wound healing in postpartum mothers in the work area of Dr. M.M. Dunda Limboto Hospital. J Commun Health Provision 2021;1:9–16. https://doi.org/10.55885/jchp.v1i1.25.
[Gerosa D, Santagata M, Martinez de Tejada B, Guittier M-J. Application of honey to reduce perineal laceration pain during the postpartum period: A randomized controlled trial. Healthcare 2022;10:1515. https://doi.org/10.3390/healthcare10081515.
Dompas R, Montolalu A, Koloay TG. Green Betel leaf water with pure honey against healing perineum’s wounds mother postpartum. J Midwifery 2022;8:1. https://doi.org/10.52365/jm.v8i1.377.
Lavaf M, Simbar M, Mojab F, et al. Comparison of honey and phenytoin (PHT) cream effects on intensity of pain and episiotomy wound healing in nulliparous women. J Complement Integr Med 2018;15:1–12. https://doi.org/10.1515/jcim-2016-0139.
Nikpour M, Delavar M, Khafri S. The use of honey and curcumin for episiotomy pain relief and wound healing: A three-group double-blind randomized clinical trial. Nur Midwifery St 2019;8:64–9. https://doi.org/10.4103/nms.nms_74_17.
Yilmaz AC, Aygin D. Honey dressing in wound treatment: A systematic review. Complemen Ther Med 2020;51:102388. https://doi.org/10.1016/j.ctim.2020.102388.
McLoone P, Tabys D, Fyfe L. Honey combination therapies for skin and wound infections: A systematic review of the literature. Clin, Cosmet Investig Derm 2020;13:875–88. https://doi.org/10.2147/CCID.S282143.
Sheil M, Chambers M, Polkinghorne A, Sharpe B. Topical application of lidocaine and bupivacaine to disbudding wounds in dairy calves: Safety, toxicology and wound healing. Animals 2021;11:1–18. https://doi.org/10.3390/ani11030869.
Bentov I, Damodarasamy M, Spiekerman C, Reed MJ. Lidocaine impairs proliferative and biosynthetic functions of aged human dermal fibroblasts. Anesth Analg 2016;123:616–23. https://doi.org/10.1213/ANE.0000000000001422.Lidocaine.
Vinklárková L, Masteiková R, Foltýnová G, et al. Film wound dressing with local anesthetic based on insoluble carboxymethycellulose matrix. J Appl Biomed 2017;15:313–20. https://doi.org/10.1016/j.jab.2017.08.002.
Bigliardi PL, Alsagoff SAL, El-Kafrawi HY, et al. Povidone iodine in wound healing: A review of current concepts and practices. Int J Surg 2017;44:260–8. https://doi.org/10.1016/j.ijsu.2017.06.073.
Hameed FM, Mohsen Al-Tomah HM, Al-Nuaimi AJ, Sadeq AW. Evaluation effect of different concentration of povidone Iodine on skin wound healing in rabbits. Journal of Physics: Conference Series 2021;1879. https://doi.org/10.1088/1742-6596/1879/2/022040.
Barbosa BF, de Moraes FCA, da Silva BAA, et al. The use of honey for cicatrization and pain control of obstetric wounds: A systematic review and meta-analysis of randomized controlled trials. Nutrients 2024;16:1–11. https://doi.org/10.3390/nu16020185.
Luxey X, Lemoine A, Dewinter G, et al. Acute pain management after vaginal delivery with perineal tears or episiotomy. Region Anesth Pain M 2024;0:1–11. https://doi.org/10.1136/rapm-2024-105478.
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