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BMC Complementary Medicine and Therapies

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Open Access 01-12-2021 | Episiotomy | Research

The effect of the Verbascum Thapsus on episiotomy wound healing in nulliparous women: a randomized controlled trial

Authors: Sahar Taleb, Maryam Saeedi

Published in: BMC Complementary Medicine and Therapies | Issue 1/2021

Abstract

Background

The pain and discomfort caused by episiotomy affect the quality of life of the mothers, so rapid and complete repair of the episiotomy is very important. Due to the effective ingredients of Verbascum Thapsus, it has been used since ancient times to treat wounds. Therefore, this study aimed to evaluate the effect of Verbascum Thapsus on episiotomy wound healing.

Methods

The study was designed as a randomized, double-blind, controlled clinical trial. Ninety-three primiparous women who were referred to Fatemeh Zahra Hospital in Saveh in 2015 were randomly divided into two groups of intervention (Verbascum Thapsus) and control (placebo). Both groups covered the episiotomy wound twice a day for 10 days with 2 cm of prescribed creams. Wound healing was assessed using the REEDA scale before the intervention and on days 1,3 and 10 after the intervention.

Results

Before the intervention, there was no statistically significant difference in terms of demographic characteristics, obstetrics, and REEDA scores between the two groups (p < 0.05). The mean scores of REEDA on days 1 and 3 in the intervention group were better than the control group but were not statistically significant. However, on the tenth day after the intervention, the mean scores of REEDA were significantly better in the Verbascum group than the placebo (p = 0.01).

Conclusions

According to the results of this study, it seems that Verbascum Thapsus is effective in repairing episiotomy wounds. The researchers hope that the results of this study can provide clinical evidence for the use of this herbal medicine in the wound healing process.

Trial registration

This study was registered in the Iranian Registry of Clinical Trials (IRCT) with the code “IRCT201404073106N15” on 02/12/2015.

Barjon K, Mahdy H. Episiotomy. [Updated 2021 Feb 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546675/.

Kalis V, Laine K, De Leeuw J, Ismail K, Tincello D. Classification of episiotomy: towards a standardisation of terminology. BJOG Int J Obstet Gynaecol. 2012;119(5):522–6. https://doi.org/10.1111/j.1471-0528.2011.03268.x.CrossRef

Levine E, Bannon K, Fernandez C, Locher S. Impact of episiotomy at vaginal delivery. J Preg Child Health. 2015;2(181):2–4.

Sultan A, Thakar R, Ismail K, Kalis V, Laine K, Räisänen S, et al. The role of mediolateral episiotomy during operative vaginal delivery. Eur J Obstetr Gynecol Reprod Biol. 2019;240:192–6. https://doi.org/10.1016/j.ejogrb.2019.07.005.CrossRef

Rasouli M, Keramat A, Khosravi A, Mohabatpour Z. Prevalence and factors associated with episiotomy in Shahroud City, northeast of Iran. Int J Womens Health Reprod Sci. 2016;4(3):125–9. https://doi.org/10.15296/ijwhr.2016.29.CrossRef

Huy NVQ. Pelvic floor and sexual dysfunction after vaginal birth with episiotomy in vietnamese women. Sexual Medicine. 2019;7(4):514–21.CrossRef

Smith J. Myles textbook for midwives. London: Taylor & Francis; 2010.

Kamel A, Khaled M. Episiotomy and obstetric perineal wound dehiscence: beyond soreness. J Obstet Gynaecol. 2014;34(3):215–7. https://doi.org/10.3109/01443615.2013.866080.CrossRefPubMed

Aradmehr M, Azhari S, Shakeri MT. Study of factors associated with postoperative pain following episiotomy in primiparous women at Mashhad Omalbanin hospital in 2012. J Midwifery Reprod Health. 2015;3(1):305–14.

10.

Derakhshanfar A, Moayedi J, Derakhshanfar G, Fard AP. The role of Iranian medicinal plants in experimental surgical skin wound healing: an integrative review. Iran J Basic Med Sci. 2019;22(6):590–600. https://doi.org/10.22038/ijbms.2019.32963.7873.CrossRefPubMedPubMedCentral

11.

Choi J, Park Y-G, Yun M-S, Seol J-W. Effect of herbal mixture composed of Alchemilla vulgaris and Mimosa on wound healing process. Biomed Pharmacother. 2018;106:326–32. https://doi.org/10.1016/j.biopha.2018.06.141.CrossRefPubMed

12.

Wagner C. Complementary and alternative medicine. The United States healthcare system: overview, driving forces, and outlook for the future. Chicago: Health Administration Press; 2020.

13.

Aradmehr M, Azhari S, Ahmadi S, Azmoude E. The effect of chamomile cream on episiotomy pain in Primiparous women: a randomized clinical trial. J Caring Sci. 2017;6(1):19–28. https://doi.org/10.15171/jcs.2017.003.CrossRefPubMedPubMedCentral

14.

Moradi M, Niazi A, Mazloumi E, Mousavi SF, Lopez V. Effect of lavender on episiotomy wound healing and pain relief: a systematic review. Evidence Based Care. 2020;10(1):61–9.

15.

Eghdampour F, Jahdie F, Kheyrkhah M, Taghizadeh M, Naghizadeh S, Hagani H. The impact of Aloe vera and calendula on perineal healing after episiotomy in primiparous women: a randomized clinical trial. J Caring Sci. 2013;2(4):279–86. https://doi.org/10.5681/jcs.2013.033.CrossRefPubMedPubMedCentral

16.

De Angelis C, Di Stadio A, Vitale S, Saccone G, Angelis MCD, Zizolfi B, et al. Use of calendula ointment after episiotomy: a randomized clinical trial. J Matern Fetal Neonatal Med. 2020:1–5. https://doi.org/10.1080/14767058.2020.1770219.

17.

Golezar S. Ananas comosus effect on perineal pain and wound healing after episiotomy: a randomized double-blind placebo-controlled clinical trial. Iran Red Crescent Med J. 2016;18(3):e21019. https://doi.org/10.5812/ircmj.21019.CrossRefPubMedPubMedCentral

18.

Abedian S, Abedi P, Jahanfar S, Iravani M, Zahedian M. The effect of lavender on pain and healing of episiotomy: a systematic review. Complem Ther Med. 2020;53:102510.CrossRef

19.

Mardani F, Hadizadeh-Talasaz F, Bahri N. Effect of medicinal plants on episiotomy wound healing in Iran: a systematic review study. Iranian J Obstet Gynecol Infertility. 2020;23(5):79–94.

20.

Demirci S, Doğan A, Demirci Y, Şahin F. In vitro wound healing activity of methanol extract of Verbascum speciosum. Int J Appl Res Nat Products. 2014;7(3):37–44.

21.

Riaz M, Zia-Ul-Haq M, Jaafar HZ. Common mullein, pharmacological and chemical aspects. Rev Bras. 2013;23(6):948–59. https://doi.org/10.1590/S0102-695X2013000600012.CrossRef

22.

Panchal MA, Murti K, Lambole V. Pharmacological properties of Verbascum thapsus—a review. Int J Pharm Sci Rev Res. 2010;5(2):73–7.

23.

Mirheydari H. Application of plants in the prevention and treatment of diseases. 5th ed. Tehran: NashreFarhange Eslami; 2004. p. 560.

24.

Khan SA, Dastagir G, Uza NU, Muhammad A, Ullah R. Micromorphology, pharmacognosy, and bio-elemental analysis of an important medicinal herb: Verbascum thapsus L. Microsc Res Tech. 2020;83(6):636–46. https://doi.org/10.1002/jemt.23454.CrossRefPubMed

25.

Akdemir Z, Kahraman Ç, Tatlı II, Akkol EK, Süntar I, Keles H. Bioassay-guided isolation of anti-inflammatory, antinociceptive and wound healer glycosides from the flowers of Verbascum mucronatum lam. J Ethnopharmacol. 2011;136(3):436–43. https://doi.org/10.1016/j.jep.2010.05.059.CrossRefPubMed

26.

Prakash V, Rana S, Sagar A. Studies on antibacterial activity of Verbascum thapsus. J Med Plants Stud. 2016;4(3):101–3.

27.

Sepahi S, Ghorani-Azam A, Sepahi S, Asoodeh A, Rostami S. In vitro study to evaluate antibacterial and non-haemolytic activities of four Iranian medicinal plants. The West Indian Med J. 2014;63(4):289–93. https://doi.org/10.7727/wimj.2013.095.CrossRefPubMed

28.

Escobar FM, Sabini MC, Zanon SM, Cariddi LN, Tonn CE, Sabini LI. Genotoxic evaluation of a methanolic extract of Verbascum thapsus using micronucleus test in mouse bone marrow. Nat Prod Commun. 2011;6(7):1934578X1100600716.

29.

Niaz A, Shah SWA, Ismail S, Ghayour A, Mehreen G, Imran K, et al. Anthelmintic and relaxant activities of Verbascum thapsus Mullein. BMC Complement Altern Med. 2012;12:29.CrossRef

30.

Rezaie A, Ebrahimi M, Issabeagloo E, Kumar M, Nazeri M, Rezaie S, et al. Study of sedative, pre-anesthetic, and anti-anxiety effects of Verbascum thapsus L. extract compared with diazepam in rats. Adv Bio Res. 2012;3(4):84–9.

31.

Murti K, Singh R, Paliwal D, Taya P, Divya S. Effect of Verbascum Thapsus L on normal and dexamethasone suppressed wound healing. Pharmacology. 2011;2:684–97.

32.

Süntar I, Tatlı II, Akkol EK, Keleş H, Kahraman Ç, Akdemir Z. An ethnopharmacological study on Verbascum species: from conventional wound healing use to scientific verification. J Ethnopharmacol. 2010;132(2):408–13. https://doi.org/10.1016/j.jep.2010.08.004.CrossRefPubMed

33.

Ghasemi F, Rezaei F, Araghi A, Tabari MA. Antimicrobial activity of aqueous-alcoholic extracts and the essential oil of Verbascum thapsus L. Jundishapur J Nat Pharm Prod. 2015;10(3):1–5.CrossRef

34.

Taleb S, Ozgoli G, Mojab F, Nsiri M, Ahvazi M. Effect of Verbascum Thapsus cream on intensity of episiotomy pain in primiparous women. Iranian J Obstetr Gynecol Infertility. 2016;19(7):9–17.

35.

Kashan FZ, Arbabi M, Delavari M, Hooshyar H, Taghizadeh M, Joneydy Z. Effect of Verbascum thapsus Ethanol Extract on Induction of Apoptosis in Trichomonas vaginalis in vitro. Infect Disorders-Drug Targets (Formerly Current Drug Targets-Infectious Disorders). 2015;15(2):125–30.

36.

Yahya S, Ozgoli G, Mojab F, Alavi Majd H, Shojaee A, Mirhaghjou N. The effect of hypericum perforatum cream on perineal pain after episiotomy in primiparous women. Iranian J Obstetr Gynecol Infertility. 2015;18(159):1–7.

37.

Davidson N. REEDA: evaluating postpartum healing. J Nurse-Midwifery. 1974;19(2):6–8.PubMed

38.

Molazem Z, Mohseni F, Younesi M, Keshavarzi S. Aloe vera gel and cesarean wound healing; a randomized controlled clinical trial. Global J Health Sci. 2015;7(1):203.

39.

Nićiforović N, Mihailović V, Mladenović M, Solujić S, Stanković M, Ivanović D. The antioxidant activity of three plant species of the Verbascum genus. International Conference Consulting on Biotechnology, 16, Čačak (Serbia), 4-5 Mar 2011. Faculty of Agriculture.

40.

Pang Y, Zhang Y, Huang L, Xu L, Wang K, Wang D, et al. Effects and mechanisms of total flavonoids from Blumea balsamifera (L.) DC. on skin wound in rats. Intern J Mol Sci. 2017;18(12):2766.CrossRef

41.

Alexandru V, Gaspar A, Savin S, Toma A, Tatia R, Gille E. Phenolic content, antioxidant activity and effect on collagen synthesis of a traditional wound healing polyherbal formula. Studia Universitatis “Vasile Goldis” Arad Seria Stiintele Vietii (Life Sciences Series). 2015;25(1):41.

42.

Yadav E, Singh D, Yadav P, Verma A. Antioxidant and anti-inflammatory properties of Prosopis cineraria based phenolic rich ointment in wound healing. Biomed Pharmacother. 2018;108:1572–83. https://doi.org/10.1016/j.biopha.2018.09.180.CrossRefPubMed

43.

Karimian V, Vahabi M, Fazilati M, Tarkesh EM. Classification the rangeland habitat of Verbascum songaricum schrenk using cluster analysis method. Desert Ecosyst Eng J. 2014;3(4):21–34.

44.

Amini S, Hassani A, Alirezalu A, Maleki R. Investigation of genetic diversity among Verbascum species in West Azerbaijan province by morphological and phytochemical markers. J Plant Prod Res. 2017;24(3):123–42.

45.

HIM A, Hussain FH, Gilardoni G, Thu ZM, Clericuzio M, Vidari G. Phytochemistry of Verbascum Species Growing in Iraqi Kurdistan and Bioactive Iridoids from the Flowers of Verbascum calvum. Plants. 2020;9(9):1066.CrossRef

46.

Karamian R, Ghasemlou F. Total phenolic content, antioxidant and antibacterial activities of three Verbascum species from Iran. J Med Plants Products. 2013;1:43–51.

47.

Selseleh M, Nejad Ebrahimi S, Aliahmadi A, Sonboli A, Mirjalili MH. Metabolic profiling, antioxidant, and antibacterial activity of some Iranian Verbascum L. species. Ind Crop Prod. 2020;153:112609. https://doi.org/10.1016/j.indcrop.2020.112609.CrossRef

48.

Alexandru V, Balan M, Gaspar A, Craciunescu O, Moldovan L. Studies on the antioxidant activity, phenol and flavonoid contents of some selected Romanian medicinal plants used for wound healing. Romanian Biotechnol Lett. 2007;12(6):3467.

49.

Asgharikhatooni A, Bani S, Hasanpoor S, Alizade SM, Javadzadeh Y. The effect of Equisetum arvense (horse tail) ointment on wound healing and pain intensity after episiotomy: a randomized placebo-controlled trial. Iran Red Crescent Med J. 2015;17(3):e25637.CrossRef

50.

Shahrahmani H, Kariman N, Jannesari S, Rafieian-Kopaei M, Mirzaei M, Ghalandari S, et al. The effect of green tea ointment on episiotomy pain and wound healing in primiparous women: a randomized, double-blind, placebo-controlled clinical trial. Phytother Res. 2018;32(3):522–30. https://doi.org/10.1002/ptr.5999.CrossRefPubMed

51.

Sohrabi-Haghdost R, Safarmashaei S. Comparison of in-vivo wound healing activity of Verbascum thapsus flower extract with zinc oxide on experimental wound model in rabbits. Adv Environ Biol. 2011;5(7):1501–9.

52.

Guo S, DiPietro LA. Factors affecting wound healing. J Dent Res. 2010;89(3):219–29. https://doi.org/10.1177/0022034509359125.CrossRefPubMedPubMedCentral

53.

Nebiuni M, Oryan S, Ayobipour M, Ramezani T. Histological effects of the smoke of Verbascum speciosum leaves on the healing of rats wounds. Nova Biologica Reperta. 2015;2(1):25–35.CrossRef

54.

Gonzalez ACO, Costa TF, Andrade ZA, ARAP M. Wound healing-a literature review. An Bras Dermatol. 2016;91(5):614–20. https://doi.org/10.1590/abd1806-4841.20164741.CrossRefPubMedPubMedCentral

55.

Dalar A, Guo Y, Konczak I. Phenolic composition and potential anti-inflammatory properties of Verbascum cheiranthifolium var. cheiranthifolium leaf. J Herbal Med. 2014;4(4):195–200. https://doi.org/10.1016/j.hermed.2014.04.004.CrossRef

Title: The effect of the Verbascum Thapsus on episiotomy wound healing in nulliparous women: a randomized controlled trial
Authors: Sahar Taleb
Maryam Saeedi
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: Episiotomy
Published in: BMC Complementary Medicine and Therapies / Issue 1/2021
Electronic ISSN: 2662-7671
DOI: https://doi.org/10.1186/s12906-021-03339-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The effect of the Verbascum Thapsus on episiotomy wound healing in nulliparous women: a randomized controlled trial

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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