Effects of Ginger (Zingiber officinale) Extract Ointment on Pain and Episiotomy Wound Healing in Nulliparous Women: A Randomized Controlled Clinical Trial

Abstract Background: An episiotomy is a common midwifery surgery that may cause severe pain and discomfort for mothers. Iran is a country with an abundant source of medicinal plants. This study hence aimed to investigate the effects of ginger (Zingiber officinale) extract ointment on the inflammation, pain, and recovery of an episiotomy incision in order to improve the quality of midwifery care in nulliparous women.Method: This triple-blind randomized clinical trial was conducted in a public hospital of Marand, Iran, on 70 nulliparous women with a mediolateral episiotomy incision. Those who met the inclusion criteria were randomly assigned to two groups of ginger extract ointment and placebo ointment at a 1:1 allocation ratio. The REEDA (redness, edema, ecchymosis, discharge, and approximation) scale and a Visual Analogue Scale (VAS) were employed to measure the episiotomy healing rate and the mean severity of pain, respectively, before discharge and 5±1 and 10±1 days after the intervention. The collected data were statistically analyzed by the chi-square test, the independent t-test, and the Mann-Whitney U test (in the case of non-normal distribution of data) in SPSS-18. The confidence level and the significance level in all statistical tests were determined to be 90% and p≤0.05, respectively.Results: There was no significant difference between participants treated with ginger extract ointment and those treated with placebo ointment in the wound healing score before the intervention (p=0.894), 5±1 days after the intervention (p=0.695), and 10±1 days after the intervention (p=0.986). There was also no significant difference between the two groups in the mean severity of pain before the intervention (p=0.924), 5±1 days after the intervention (p=0.576), and 10±1 days after the intervention (p=0.400). Conclusion: The study findings revealed that the 200 mg dose of ginger ointment could not significantly improve the pain and increase the healing rate of episiotomy wounds 5 and 10 days after the intervention. It seems that more and longer studies with different doses of this ointment are needed before coming to a definitive conclusion about its effects.Trial Registration: IRCT Registration Number: IRCT20110922007618N9, registered on August 14, 2020 (IR.TBZMED.REC.1399.333)