Herbal Medicine in Episiotomy Wound Healing: A Systematic Review

Introduction: Episiotomy is a common obstetric intervention following vaginal delivery and is frequently associated with pain, delayed wound healing, and postpartum discomfort. Inadequate healing of episiotomy wounds may result in infection, prolonged pain, and long-term perineal complications. Traditional and complementary medicine, particularly herbal therapies, has been increasingly investigated as a potential strategy to enhance wound healing and reduce pain after episiotomy. This systematic review aimed to evaluate the effects of herbal medicines on episiotomy wound healing and pain reduction. Methods: This systematic review was conducted in accordance with PRISMA guidelines. Electronic databases including PubMed, Scopus, Web of Science, and Google Scholar were systematically searched for interventional studies published between 2000 and November 21, 2024. Eligible studies were clinical trials evaluating the effects of herbal medicines on episiotomy wound healing and/or pain outcomes among postpartum women. Study quality was assessed using the Joanna Briggs Institute critical appraisal checklist. Results: Of 304 identified records, 73 studies met the inclusion criteria. Most studies were randomized or quasi-experimental trials conducted among primiparous women. Herbal interventions including Aloe vera gel, lavender oil, olive oil, green tea extract, yarrow ointment, chamomile cream, and Hypericum perforatum were the most frequently investigated. The majority of studies reported significant improvements in wound healing scores and/or reductions in pain intensity compared with placebo, routine care, or conventional treatments. Based on the JBI critical appraisal assessment of the 73 included studies, 51 studies (69.9%) were classified as high quality, 21 (28.8%) were classified as moderate quality, and one study (1.4%) was classified as low quality. Discussion: Overall, the findings suggest that several herbal medicines—particularly Aloe vera, lavender, and olive oil—may accelerate episiotomy wound healing and alleviate pain. However, heterogeneity in study design, intervention formulations, and outcome measures limits direct comparison across studies. Conclusion: Herbal medicines appear to be promising complementary interventions for episiotomy wound management. Nevertheless, further high-quality, multicenter randomized controlled trials with standardized protocols and long-term follow-up are required to confirm their efficacy and safety.