The effect of hydrogel dressing on the process of episiotomy wound healing

Abstract

Childbirth is an event that affects the mother both physically and emotionally in the short and long term. About a third of women give birth physiologically, but the rest undergo interventions. One of the most common interventions during birth is the use of an episiotomy, which is the surgical widening of the vaginal opening through an incision in the perineum during the second stage of labor. Accordingly, after the incision, there is a need to create favorable conditions for better healing and restoration of the episiotomy wound.

Purpose - to study the effectiveness of hydrogel dressings with lidocaine in the management of episiotomy wounds.

Materials and methods. The prospective randomised study analysed clinical, laboratory and anamnestic data of 123 first-time mothers with episiotic wounds (Kyiv City Maternity Hospital No. 5, 2021-2022). Participants were divided into two groups: a comparison group (63 patients), which received standard treatment; a study group (60 patients), which additionally received hydrogel dressings with lidocaine. Wound healing was assessed by the REEDA scale on the 1st, 2^nd, 3^rd and 10^th day after delivery. Statistical analysis was performed using the Mann-Whitney test and the statistical package EZR v. 1.54.

Results. The results of the analysis of the total values according to the REEDA scale showed that the process of episiotic wound healing between the two groups of patients proceeded similarly on the 1^st day of observation (5 (3.25-6) points - in the comparison group; 4 (3-6) points - in the study group; p=0.589). At the end of the 2^nd day of follow-up, the results indicated a statistically significant difference (7 (6-8) points in the comparison group, 6 (4-7.5) points in the study group; p=0.001). The analysis of the sum of points at the end of the 3^rd and 10^th days of observation showed statistically significant differences (6 (5-7) and 4 (4-5) - in the comparison group (p=0.014); 6 (3-6.5) and 3 (3-4) - in the study group (p<0.001), respectively).

Conclusions. The use of hydrogel dressing with lidocaine in the management of the episiotomy wound reduces the scores according to the REEDA scale on the 2^nd, 3^rd and 10^th days after delivery, which indicates a more effective episiotomy healing process compared to patients with a comparison group. Hydrogel dressing with lidocaine contribute to better healing of episiotomy wounds, proving their usefulness in clinical practice.

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.

No conflict of interests was declared by the authors.