نیره اسعدی

Episiotomy is the most common surgical intervention at the end of second stage of delivery and perineal pain is the most common complication of episiotomy. Since this pain affects the quality of life and relationships between the mother and baby, different studies have been conducted in order to expedite treatment of episiotomy wound healing and pain relief. Therefore, this study was performed with aim to have a systematic review on the studies performed to reduce episiotomy pain and improve wound healing in Iran.
In this systematic review, the related information were searched from databases of IRCT, Iranmedex, Magiran, Irandoc, Medlib, Google Scholar, SID, Proquest, Scopus, Pubmed and Science Direct with the keywords of “episiotomy, wound healing, perineum, pain” to December 2015. Then, the articles which obtained score of 3 or higher were entered to the study based on Jadad criteria. Moreover, data were analyzed qualitatively.
Finally, 36 clinical trials which met the inclusion criteria were evaluated. The surveys showed that the several methods were used to reduce the pain intensity and improve wound healing such as herbs (lavender, Curcuma, etc), chemical drugs (phenytoin and lidocaine, etc.) and non-pharmacological methods (cryotherapy and ...). Among all the interventions, Lavender, Olea europaea, Aloe vera, Curcuma and Cryotherapy led to greatest pain reduction and fastest recovery of episiotomy wound.
Lavender, Olea europaea, Aloe vera, Curcuma and Cryotherapy are the most effective treatments for episiotomy wound. However, more accurate studies with higher sample are required for definite judgment about the effectiveness of these interventions.

Nipple fissure is one of the most common problems in breastfeeding women and the main reason for the early discontinuation of breastfeeding. Due to the importance of breastfeeding, the present study was performed with aim to review the clinical trials conducted on the treatment of sore nipple and nipple pain in breastfeeding women.
In this systematic review, all local databases were searched with the keywords of “sore nipple” and “clinical trial” and databases of Google Scholar, PubMed, ProQuest, Scopus, Science Direct and Medline with the keywords of “sore nipple” and “clinical trial” were searched to November 2015 with no time and language limitations. All the articles were reviewed based on the Jadad scale and those scoring ≥3 were selected. The results were reported qualitatively.
A total of 14 articles meeting the inclusion criteria were ultimately examined. Among the treatments examined in these studies, Lanolin along with a nipple shield, Aloevera gel, menthol essence and warm compress led to more decrease in severity of pain and the fastest recovery of sore nipples.
Lanolin along with a nipple shield, Aloevera gel, menthol essence and warm compress are the most effective treatments for sore nipples. Nevertheless, a definitive judgment about the effectiveness of these interventions requires more accurate studies with adequate sample sizes. Studies conducted on sore nipples and their treatment are scattered and drawing conclusions about the interventions is not possible due to the limited number of studies.