Assessment of the Efficacy of Local Aplication Of Yashtimadhu Siddha Ghrit in Vitapchhed Vrana with special reference to Episiotomy Wound: Randomized Control Trial.

Episiotomy is
planned surgical incision given in the medial or medio-lateral aspect of the
perineum to reduce the maternal and neonatal trauma and morbidity associated
with delivery. It has short term benefits of episiotomy for doctors is easy
to repair compared to a spontaneous perineal lacerations. It also decreases
postpartum pain and reduction in severe or 3rd and 4th
degree perineal tears. Now days the term episiotomy comes into Conside- ration
because the perineal tears can gives many complications, like infection,
sepsis. But healing becomes problematic even after suturing (as the vaginal
PH becomes alkaline in post partum period acc. to modern science) there may
be soiling by fecal matter and gives complications.The degree of
perineal pain and discomfort associated with preineal tear is often underestimated. Pain often interferes with basic daily activities of the woman such as
walking, sitting and act of micturition and that of defecation and also
negatively impact on motherhood experiences. Hence a timely intervention of
episiotomy can prevent the maternal morbidity.

During post natal period, puerperal sepsis is one of the major concern. As the perineum is highly susceptible to infection due to different secretions like vaginal discharges, faeces and urine, episiotomy wound requires a proper care which could otherwise be self limiting due to high vascularity of perineal area. If not taken care , episiotomy wound may lead to immediate complications like infection, dehiscence or remote complications like dyspareunia, scar endometriosis or chances of perineal lacerations in subsequent labour.

Episiotomy wound can be compared to Chhina Vrana(a type of Sadhyo Vran) and treatment can be planned as that of sadhyo vran. Acharya Sushruta has mentioned Shashti Upakrama for Vrana Chikitsa for better healing and pain management, where alepana being one among them.

Thus, a sincere
attempt has been made in the present study to hasten the rate of episiotomy
wound healing by application of Yashtimadhu Siddha Ghrit.