Episiotomy wound healing and pain management in ayurveda: a case study
Journal name: Ayushdhara
Original article title: Episiotomy wound healing and pain management in ayurveda: a case study
AYUSHDHARA is an international peer-reviewed journal. It focuses on research in Ayurveda, Yoga, Unani, Siddha, Homeopathy, Allopathy, and Pharmaceutical Sciences.
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Jyoti Jain
MD. Scholar, Department of Prasuti and Stri Roga, National Institute of Ayurveda, Jaipur
Hetal H.Dave
Assistant Professor, Department of Prasuti and Stri Roga, National Institute of Ayurveda, Jaipur
K.Bharathi
Professor and HOD, Department of Prasuti and Stri Roga, National Institute of Ayurveda, Jaipur
B.Pushpalataha
Associate Professor, Department of Prasuti and Stri Roga, National Institute of Ayurveda, Jaipur
Ayushdhara:
(A peer-reviewed, bi-monthly open-access journal)
Full text available for: Episiotomy wound healing and pain management in ayurveda: a case study
Year: 2019
Copyright (license): CC BY-NC-SA 4.0
Download the PDF file of the original publication
Summary of article contents:
Introduction
Episiotomy is a commonly performed surgical incision on the perineum and posterior vaginal wall during the second stage of labor to facilitate vaginal delivery and prevent irregular perineal tears. However, postpartum complications such as pain, swelling, infection, and discomfort can arise, significantly affecting the daily activities of women. Current medical treatments for episiotomy wounds often include NSAIDs and antibiotics, which may have adverse effects. This case study focuses on a 20-year-old postpartum patient who experienced complications from an open episiotomy wound and explores the effectiveness of Ayurvedic treatments for wound healing and pain management.
Efficacy of Ayurvedic Treatments for Wound Healing
The study utilized a combination of Ayurvedic interventions, including Panchvalkal kwatha for washing the wound, Yoni Dhoopan with Haridra and Guggulu, and local application of Jatyadi Taila, alongside oral administration of Triphala Guggulu. Notably, Panchvalkala is a blend of five medicinal plants known for their antiseptic and anti-inflammatory properties, which aid in wound purification and healing. The patient began to show signs of improvement after two days, with granulation tissue forming by the seventh day, and complete wound closure achieved by the tenth day. This illustrates the potential effectiveness of Ayurvedic methods in managing episiotomy complications.
Importance of Holistic Ayurvedic Approaches
Ayurveda provides a holistic approach not only targeting the symptoms of wounds but also promoting overall health. The treatments employed in this case possess qualities that facilitate wound cleaning (Vrana Shodhana), healing (Vrana Ropana), and relief from discomfort (Kandughna). Ingredients such as Triphala Guggulu and Jatyadi Taila are highlighted for their wound-healing capabilities due to their anti-inflammatory, antimicrobial, and antioxidant properties. This comprehensive approach supports faster recovery and enhances patient well-being, suggesting that Ayurvedic remedies could serve as a beneficial alternative or complement to conventional treatment methods for episiotomy care.
Conclusion
The Ayurvedic regimen demonstrated in this case study effectively managed the episiotomy wound, resulting in complete healing within ten days. The combination of Panchvalkal kwatha, Yoni Dhoopan, Jatyadi Taila, and Triphala Guggulu provided significant benefits in terms of wound healing and pain relief. These findings underscore the value of integrating traditional Ayurvedic treatments into postpartum care, offering a promising alternative to allopathic medications that may have adverse effects. Further research with larger sample sizes is needed to reinforce these findings and explore the full potential of Ayurvedic solutions in wound management.
FAQ section (important questions/answers):
What is episiotomy and why is it performed during childbirth?
Episiotomy is a surgical incision made on the perineum during the second stage of labor to facilitate vaginal delivery and prevent irregular tearing. It helps to enlarge the vaginal introitus and can aid in a smoother delivery process.
What complications can arise from an episiotomy?
Complications from episiotomy can include pain, swelling, wound infection, discomfort, and issues like rectal pain. These complications can interfere with a woman's daily activities and overall recovery post-delivery, making effective management essential.
How does Ayurveda approach episiotomy wound healing?
Ayurveda utilizes compounds like Panchvalkala kwatha, Yoni Dhoopan with Haridra and Guggulu, and Jatyadi Taila for episiotomy wound management. This regimen aims to reduce infection, promote healing, and manage pain effectively, showing promising results in wound recovery.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for 鈥淓pisiotomy wound healing and pain management in ayurveda: a case study鈥�. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Drug:
A substance used in medicine to treat illness, resulting from Ayurveda's natural remedies to assist wound healing and pain management. The study involved using traditional herbs known for their multiple properties in treating episiotomy wounds.
2) Vrana:
A Sanskrit term referring to wounds or ulcers. Ayurvedic texts like those from Acharya Sushruta provide numerous methods for 'Vrana-shodhana' (wound cleansing) and 'Vrana-ropana' (wound healing) using various herbal formulations. The study evaluates these ancient techniques.
3) Guggulu:
An important Ayurvedic resin known for its anti-inflammatory and analgesic properties, often used in wound healing formulations. In the study, Guggulu was used in 'Triphala Guggulu' and 'Yoni Dhoopan' to treat an episiotomy wound effectively.
4) Jatyadi:
Refers to Jatyadi Taila, an Ayurvedic medicated oil, used externally for wound healing. Its ingredients, such as Haridra and Karanja, have anti-inflammatory, antioxidant, and antimicrobial properties aiding in wound cleansing and healing.
5) Ayurveda (Ayus-veda):
An ancient Indian system of medicine focusing on natural and holistic treatments for health and wellness, emphasizing the balance of bodily doshas (humors). This case study utilized Ayurvedic treatments for episiotomy wound healing.
6) Ropana:
A Sanskrit term meaning healing, particularly of wounds. Ayurvedic texts detail 'Vrana-ropana' methods involving various herbs and formulations to accelerate tissue healing, as demonstrated in the case study with episiotomy wounds.
7) Triphala (Tri-phala):
A classical Ayurvedic formulation composed of three fruits: Haritaki, Vibhitaki, and Amalaki. It is known for its healing, anti-inflammatory, and digestive properties. Triphala was used internally in the study for its systemic benefits.
8) Taila (Thaila):
An Ayurvedic term for oil used in medicinal treatments. In the study, Jatyadi Taila, containing therapeutic herbs, was applied to the episiotomy wound to promote healing and reduce infection.
9) Pain:
A significant symptom managed in the study, resulting from an episiotomy wound. Ayurvedic treatments like Triphala Guggulu and Jatyadi Taila were used for their analgesic properties to reduce pain and promote comfort.
10) Haridra:
The Sanskrit name for turmeric (Curcuma longa), renowned for its anti-inflammatory, antimicrobial, and wound-healing properties. Haridra was used in both 'Yoni Dhoopan' and in Jatyadi Taila in the study.
11) Triphalaguggulu (Triphala-guggulu):
An Ayurvedic formulation combining Triphala and Guggulu, known for its wound-healing, anti-inflammatory, and analgesic properties. It was used orally in the study to aid the healing of the episiotomy wound.
12) Shothahara (Sothahara, Shotha-hara):
An Ayurvedic term denoting anti-inflammatory action. Many of the drugs used in the study, like Panchvalkal Kwatha and Triphala Guggulu, possess Shothahara properties that help in reducing inflammation and swelling.
13) Jaipur:
The location of the National Institute of Ayurveda in India, where the case study on episiotomy wound healing and pain management was conducted.
14) Vranaropana (Vrana-ropana):
A specific term in Ayurveda that refers to the process of healing wounds. Acharya Sushruta described various herbs and methods for effective 'Vrana-ropana', utilized in the study for treating an episiotomy wound.
15) Shodhana (Sodhana):
Another term for Shodhana in Ayurveda, referring to cleansing or purifying treatments, used in wound management as described in the study.
16) Prasuti:
The Ayurvedic term for obstetrics, relating to childbirth and postpartum care. The study was conducted in the Department of Prasuti and Stri Roga, focusing on healing episiotomy wounds.
17) Inflammation:
A bodily response to injury often resulting in pain, redness, and swelling. The Ayurvedic treatments used in the study, like Triphala Guggulu and Jatyadi Taila, showed anti-inflammatory properties to manage symptoms of inflammation.
18) Utkartana:
Ayurvedic term that refers to incisions or surgical wounds, similar to what occurs in episiotomy. The study used traditional Ayurvedic treatments for Utkartana to heal and manage the wound effectively.
19) Shotha (Sotha):
An Ayurvedic term meaning swelling or edema, often following injury or surgery like an episiotomy. Anti-inflammatory drugs like Triphala Guggulu and Jatyadi Taila were used in the study to manage Shotha.
20) India:
The country where the National Institute of Ayurveda in Jaipur is located, conducting research including this case study on Ayurvedic treatment of episiotomy wounds.
21) Vedanasthapana (Vedana-sthapana):
An Ayurvedic action that means pain-relieving. The study used several Ayurvedic formulations, such as Jatyadi Taila and Triphala Guggulu, known for their Vedanasthapana properties.
22) Vranashodhana (Vranasodhana, Vrana-shodhana):
[see source text or glossary: Vrana-sodhana]
23) Dushtavrana (Dustavrana, Dusta-vrana, Dushta-vrana):
A term referring to chronic or non-healing wounds that may be infected. Ayurvedic treatments such as Jatyadi Taila were used in the study to manage Dushta Vrana and promote healing.
24) Nyagrodha:
The Sanskrit name for the Banyan tree (Ficus benghalensis), part of the Panchavalkala group of herbs used in Ayurvedic wound healing formulations like Panchvalkal Kwatha in the study.
25) Striroga (Stri-roga):
A variant spelling of Stri-roga which means gynecology in Ayurveda where the case study was conducted at the National Institute of Ayurveda.
26) Udumbara:
Another name for the cluster fig tree (Ficus glomerata), part of the Panchavalkala group used in the study to treat the episiotomy wound with its antimicrobial and anti-inflammatory properties.
27) Swelling:
A common symptom of wounds like those from an episiotomy. The anti-inflammatory properties of Ayurvedic treatments used in the study, such as Triphala Guggulu and Jatyadi Taila, helped reduce swelling.
28) Karanja (Karamja):
An herbal ingredient (Pongamia pinnata) in Jatyadi Taila used for its antimicrobial and wound-healing properties to treat the episiotomy wound in the study.
29) Samaka (Shamaka):
An Ayurvedic term referring to the pacification or alleviation of doshas or symptoms. In the study, herbs with 'Shamaka' properties helped to reduce pain and inflammation following episiotomy.
30) Pradhan:
A term that means predominant or primary, used to describe the main qualities or attributes of Ayurvedic herbs involved in wound healing.
31) Dushta (Dusta):
An Ayurvedic term meaning impure or infected, referring to wounds that are non-healing or complicated. The study used Ayurvedic formulations for Dushta Vrana to promote healing.
32) Tikta:
One of the six tastes in Ayurveda, meaning bitter. Tikta herbs like those in Jatyadi Taila are used in wound healing for their detoxifying and antimicrobial properties.
33) Ghana:
Means thick or dense, used in Ayurveda to describe the concentrated form of herbal extracts or properties of certain herbs like Kushta Ghana which denotes cleansing properties.
34) Ulcer:
A type of chronic wound, referred to as Vrana in Ayurveda. The study addressed the healing of an episiotomy wound using Ayurvedic methods similar to treatments for ulcers.
35) Blood:
Vital fluid in the body. Ayurvedic treatments like those in the study also aim at 'Raktaprasadana' (blood purification) to promote overall health and healing of wounds.
36) Roga:
Means disease in Ayurveda. The study was conducted in the Department of Prasuti and Stri Roga, focusing on treating episiotomy wounds, a postpartum complication.
37) Yoni (Yonin):
Sanskrit term for the female reproductive system. The study included 'Yoni Dhoopan', an Ayurvedic fumigation treatment for postpartum care, particularly for healing episiotomy wounds.
38) Vata:
One of the three doshas in Ayurveda representing air and ether elements. Imbalance in Vata can affect healing; the study used Vata-shamaka (Vata-pacifying) herbs to manage the wound.
39) Azadirachta indica:
Scientific name for Neem, known for its antimicrobial and wound-healing properties. Used in Jatyadi Taila, it helped treat the episiotomy wound in the study.
40) Curcuma longa:
Scientific name for turmeric, known as Haridra in Sanskrit. It has anti-inflammatory and antimicrobial properties used in the study鈥檚 Ayurvedic treatments for wound healing.
41) Ficus religiosa:
Scientific name for the sacred fig, known in Ayurveda as Ashvatha. Part of the Panchavalkala herb group used in wound healing formulations in the study.
42) Daruharidra (Daru-haridra):
An herb (Berberis aristata) known for its antimicrobial and wound-healing properties, used in Jatyadi Taila for treating the episiotomy wound in the study.
43) Kaphadosha (Kaphadosa, Kapha-dosha):
One of the three doshas representing earth and water elements. Imbalance of Kapha can lead to persistent swelling and infection; the study utilized Kapha-nashaka (Kapha-reducing) herbs.
44) Discussion:
Part of the scientific study where results are analyzed and interpreted. The discussion in the study highlighted the effectiveness of Ayurvedic treatments in managing episiotomy wounds.
45) Kandughna (Kandu-ghna):
Means anti-itching property in Ayurveda. The herbs used in the study for 'Yoni Dhoopan' included Haridra, which has Kandughna properties to alleviate itching around the wound.
46) Flavonoid:
A group of phytonutrients found in plants with anti-inflammatory and antioxidant properties. The flavonoids present in the herbs used in the study contributed to wound healing.
47) Haritaki:
One of the three fruits in Triphala, known for its healing and anti-inflammatory properties. Haritaki was part of the internal medicine that aided wound healing in the study.
48) Bharathi:
One of the authors of the case study and a Professor at the National Institute of Ayurveda, specializing in Prasuti and Stri Roga.
49) Medicine:
Refers to drugs or treatments used to manage health conditions. In the case study, Ayurvedic medicine was employed to treat an episiotomy wound effectively.
50) Samhita:
Classical Ayurvedic texts outlining theories and treatments in Ayurveda. The study's methodology is based on practices found in these ancient texts like Charaka Samhita.
51) Amalaki:
One of the three fruits in Triphala, known for its antioxidant and healing properties. It was part of the internal medication used in the study to aid in wound healing.
52) Pippali (Pippalin):
An herb known for its digestive and anti-inflammatory properties, also part of Triphala Guggulu used in the study for internal administration to treat the wound.
53) Parisa (Parisha):
An herb (Thespesia Populanea) part of the Panchavalkala group used in the study for its astringent and wound-healing properties in formulations like Panchvalkal Kwatha.
54) Plaksha (Plaksa):
Refers to the tree Ficus lacor, another member of the Panchavalkala group used in Ayurvedic formulations for its wound-healing properties demonstrated in the study.
55) Valkala:
Bark of certain trees used in Ayurvedic medicine for their medicinal properties. In the study, Panchvalkala Kwatha (a decoction of five tree barks) was used for wound cleansing and healing.
56) Kashaya (Kasaya):
One of the six tastes in Ayurveda, meaning astringent. Herbs with Kashaya Rasa, like those in the Panchvalkala Kwatha, are beneficial for wound healing due to their drying and tightening effects.
57) Dravya:
Means substance or material in Ayurveda, usually referring to medicinal herbs or ingredients. The various Dravyas used in the study had multiple healing properties for the wound.
58) Vedana:
A term for pain or soreness in Ayurveda. Treatments such as Vedanasthapana herbs used in the study like Guggulu helped alleviate pain from the episiotomy wound.
59) Ruksha (Ruksa):
An Ayurvedic term describing the drying quality. Herbs with Ruksha Guna were used in the study to help dry out the wound and prevent infection.
60) Kashya (Kasya):
Refers to the astringency or drying property of certain herbs used in Ayurveda for wound treatment. This property helps in reducing secretion and encouraging healing as applied in the study.
61) Mahila:
Meaning woman or female in Sanskrit. The term is relevant to the case study as it focuses on a postpartum female patient鈥檚 care for an episiotomy wound.
62) Labour (Labor):
Refers to childbirth. The study focuses on wound healing post-episiotomy, an incision made during labour to facilitate delivery.
63) Powder:
A form in which some Ayurvedic medicines are administered. In the study, Triphala Guggulu tablets were made into powder and taken with lukewarm water to aid healing.
64) Cotton:
Used in conventional wound care methods for cleaning and dressing wounds. Contrast to Ayurvedic methods in the study which use herbal preparations.
65) Indian:
Denotes anything related to India. The National Institute of Ayurveda in Jaipur, India, conducted the study demonstrating traditional Indian medicine's effectiveness in wound healing.
66) Dosha (Dosa):
The three fundamental bio-elements in Ayurveda: Vata, Pitta, and Kapha. Balancing these doshas is essential for health, as seen in the study's use of dosha-pacifying herbs.
67) Kapha:
One of the three doshas in Ayurveda related to water and earth, often linked with lethargy and congestion. The herbal treatments in the study were designed to balance Kapha for optimal healing.
68) Rakta:
Means blood in Ayurveda. Treatments enhancing 'Raktaprasadana' (blood purification) were part of the study to ensure proper blood flow and healing of the wound.
69) Ushna (Usna):
Means hot in Sanskrit, relating to substances with heating qualities. Ushna dravyas are often used in Ayurveda for their digestive and circulatory benefits.
70) Krimi (Krmi):
Means worms or parasites. Ayurvedic herbs like Haridra in the study possess Krimighana (antiparasitic) properties to help prevent infections in wounds.
[Note: The above list is limited to 75. Total glossary definitions available: 80]
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