The focus of the dissertation lies in an in-depth exploration of the healing dynamics surrounding episiotomy wounds, aiming to elevate the efficacy of the healing process by implementing a comprehensive array of therapeutic and preventative interventions.
To date, debates among obstetrician-gynecologists persist regarding the routine use of episiotomy. Concurrently, there is a paucity of data concerning the effectiveness of its routine episiotomy during childbirth. It is pertinent to note that the intricacies of pregnancy and childbirth, coupled with the high incidence of sexually transmitted infections and chronic persistent fungal and bacterial infections, including diabetes mellitus—both gestational and otherwise—exacerbate the healing of episiotomy wounds in the postpartum period. These realities underscore the necessity for effective approaches to managing episiotomy wounds in the postpartum period, with the overarching goal of minimizing potential complications.
The primary objective of this work is to formulate a comprehensive regimen of therapeutic and preventive measures to enhance the repair of episiotomy wounds, considering clinical, immune, and stress-related factors.
Objectives of the study:
1. To establish the regulatory features of cytokines and heat shock proteins during the repair of episiotomy wounds.
2. To determine the role and provide an assessment of the impact of stress and the severity of pain sensations during the healing process of episiotomy wounds.
3. To investigate the influence of hydrogel dressings on the process of repairing episiotomy wounds.
4. Utilizing the gathered data, the aim is to formulate and execute a comprehensive set of therapeutic and preventative strategies tailored to enhance the healing process of episiotomy wounds.
5. Evaluate the efficacy of the suggested therapeutic and preventative regimen in the management of episiotomy wounds.
According to the research objectives and to address the tasks at hand, the work was conducted in four stages. During the first stage of the study, an examination was carried out, encompassing clinical, laboratory, and anamnestic data of 123 primiparous patients with episiotomy wounds. The allocation of patients with episiotomies into groups was randomized: odd or even history numbers were used, with odd numbers assigned to the comparison group and even numbers to the intervention group. Thus, the first group (comparison) comprised 63 women (mean age 28 ± 5.3 years), for whom standard methods of episiotomy wound care were applied, including antiseptic treatment of sutures, ensuring proper wound care, and limiting physical activity in the perineal area. The second group (intervention) consisted of 60 women (mean age 28.2 ± 5.1 years), who, in addition to standard care for episiotomy wounds, underwent an enhanced complex of therapeutic and preventive measures using hydrogel dressings containing lidocaine.
