Effect of honey on pain severity and episiotomy healing: A systematic review

Irani, Morvarid; Rahmanian, Seyyedeh Adeleh; Aradmehr, Maryam

Volume 13, Issue 3 (9-2025) jmsthums 2025, 13(3): 93-109 | Back to browse issues page

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Irani M, Rahmanian S A, Aradmehr M. Effect of honey on pain severity and episiotomy healing: A systematic review. jmsthums 2025; 13 (3) :93-109
URL: http://jms.thums.ac.ir/article-1-1392-en.html

Effect of honey on pain severity and episiotomy healing: A systematic review

Morvarid Irani¹

, Seyyedeh Adeleh Rahmanian²

, Maryam Aradmehr¹

1- Department of Midwifery, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
2- Department of Nursing, Shirvan Faculty of Nursing, North Khorasan University of Medical Sciences, Bojnurd, Iran

Abstract: (28 Views)

Background & Aim: Episiotomy, as a surgical procedure to enlarge the pelvic outlet, may cause complications such as pain and perineal injury. This study aimed to evaluate and analyze previous research on the effect of honey on pain severity and episiotomy wound healing through a systematic review of clinical trials.
Methods: In this systematic review (based on PRISMA guidelines), related studies were searched in authentic databases using the keywords episiotomy, honey, pain, wound healing, and perineum and their English equivalents, without language or time restrictions, until November 2024. The quality of clinical trials was assessed using the Haddad scale, and studies with a score of 3 or higher were included. Data were analyzed qualitatively.
Results: Out of 208 retrieved articles, seven eligible clinical trials were included. These studies, involving a total of 981 participants, investigated the effect of honey on pain severity and episiotomy wound healing. Among three studies assessing the effect of honey on episiotomy-related pain, only one reported a significant reduction in pain (p=0.001). However, among five studies evaluating wound healing, four found that honey had a positive effect on episiotomy wound healing (p<0.05).
Conclusion: Honey appears to promote episiotomy wound healing and may be more effective in enhancing wound recovery than in reducing pain severity. However, further well-designed studies are needed to draw definitive conclusions.

Keywords: Honey, Episiotomy, Pain, Perineum, Wound Healing

Full-Text [PDF 359 kb] (55 Downloads)

Type of Study: Applicable | Subject: General
Received: 2025/01/16 | Accepted: 2025/06/1 | Published: 2025/11/17

References

1. Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams Obstetrics, 26ed, New York: McGraw Hill 2023. P .400 - 406,831.

2. Kariman N, Amani R. Assessing comparison the effect of cooling gel pads and topical olive oil on the intensity of episiotomy pain in primiparous women. Cmja 2015. 4 (4): 977-986.

3. Ghiasvand M, Nahidi F, Sedigh Mobarakabadi S, Broumandnia N, Sharifnia H. Prevalence and meta-analysis of episiotomy in the Middle East. IJOGI 2021. 24(4): 90-99.

4. Behmanesh F, Aghamohammadi A, Zeinalzadeh M, Khafri S. Effects of olive oil sitz bath on improvement of perineal injury after delivery. Koomesh 2013. 14(3): 30-315.‏

5. Mardani F, Hadizadeh- Talasaz F, Bahri N. Effect of Medicinal Plants on Episiotomy Wound Healing in Iran: A Systematic Review Study. IJOGI 2020. 23(5): 79-94.

6. Hadizadeh-Talasaz F, Mardani F, Bahri N, Rakhshandeh H, Khajavian N, Taghieh M. Effect of Rosemary Cream on Episiotomy Wound Healing in Primiparous Women: A Randomized Clinical Trial. BMC Complement Med Ther 2022. 22(1):226. [DOI:10.1186/s12906-022-03675-1]

7. Shahrahmani H, Kariman N, Jannesari S, Ghalandari S, Asadi N. A systematic review on the type of treatment methods to reduce pain and improve wound healing in Iran. IJOGI 2016. 19(9): 17-31.

8. Vallianou NG, Gounari P, Skourtis A, Panagos J, Kazazis C. Honey and its anti-inflammatory, anti-bacterial, and anti-oxidant properties. General Med 2014. 2(2):132. [DOI:10.4172/2327-5146.1000132]

9. Majtan J. Honey: an immunomodulator in wound healing. Wound Repair Regen 2014. 22(2):187-92. [DOI:10.1111/wrr.12117]

10. Ghaderbasti S, Sayed Kaboli K, Farhadi Far F, Shahoei R. Comparison of the effects of honey cream and olive oil cream on episiotomy repair. IJOGI 2022. 25(8): 81-93.

11. Lotfi S, Sabiza S, Naddaf H, & Rezaie A. Histopathologic Evaluation of Honey-Zinc Oxide Combination on Full-Thickness Experimental Wound Healing in Rats. Iran Vet J 2021. 17(3): 47-58.‏

12. Naik P P, Chrysostomou D, Cinteza M, Pokorna A, Cremers N A. When time does not heal all wounds-the use of medical grade honey in wound healing: A case series. JWC 2022. 31(7): 548-558.‏ [DOI:10.12968/jowc.2022.31.7.548]

13. Pleeging C C, Wagener F A, De Rooster H, Cremers N A. Revolutionizing non-conventional wound healing using honey by simultaneously targeting multiple molecular mechanisms. Drug Resistance Updates 2022. 62:1-10.‏ [DOI:10.1016/j.drup.2022.100834]

14. Amani R, Kariman N, Mojab F, Alavi MH, Majidi S. Comparison of the effects of cold compress with gel packs and topical olive oil on episiotomy wound healing. J Babol Univ Medical Sci 2015. 17(11):7-12.

15. Rahmanian SA, Irani M, Aradmehr M. The Effect of Medicinal Plants on Gynecological and Obstetric Hemorrhages: A Systematic Review of Clinical Trials. IJOGI 2022. 25(7): 113-127.

16. Gerosa D, Santagata M, Martinez de Tejada B, Guittier M.-J.

17. Application of Honey to Reduce Perineal Laceration Pain during the

18. Postpartum Period: A Randomized Controlled Trial. Healthcare 2022. 10(1515). [DOI:10.3390/healthcare10081515]

19. 17 Torkashvand Sh, Jafarzadeh Kenarsari F, Donyaei Mobarrez Y, Gholami Chaboki B. Effectiveness of Olea Herbal Ointment on Episiotomy Wound Healing Among Primiparous Women: A Randomized Clinical Trial. JJNPP 2021. 16(3), 6. magiran.com/p2306443 [DOI:10.5812/jjnpp.104570]

20. 18 Jafarzadeh-Kenarsari F, Torkashvand S, Gholami - Chaboki B, Donyaei-Mobarrez Y. The effect of olea ointment on post-episiotomy pain severity in primiparous women: A paralleled randomized controlled clinical trial. Iranian J Nursing Midwifery Res 2019. 24:348-54. [DOI:10.4103/ijnmr.IJNMR_151_18]

21. 19 Nikpour M, Delavar MA, Khafri S, Ghanbarpour A, Moghadamnia AA, Esmae lzadeh S, et al. The use of honey and curcumin for episiotomy pain relief and wound healing: A three group double blind randomized clinical trial. Nurs Midwifery Stud 2019. 8:64 9.

22. 20 Lavvaf M, simbar M, Mojab F, Alavi Majd H, samimi M. Comparison of honey cream and phenytoin cream effects on episiotomy wound healing in nulliparous women. cmja 2015. 5 (1) :1091-1104

23. 21 Manjula, P., Rao, A.C., Ranjani, P. Effectiveness of Honey Versus Betadine on Episiotomy Wound Healing. JNUR 2012. 2(1), 32-37. [DOI:10.26634/jnur.2.1.1821]

24. 22 Ziyai T, Pourhaidari M, Nazifkar H and Kazemnejad E. Comparison of episiotomy wound healing with chromic and vicryl cutgut sutures in Zao women: a clinical trial. J of Nurs and Midwifery Faculty (Advances in Nursing and Midwifery) 2015. 25(92):1-5.

25. 23 Shah Rahmani H, Kariman N, Jan Nisari Sh, Qalandari S and Asadi N. A systematic review of various treatment methods to reduce pain and heal episiotomy wounds in Iran. IJOGI 2015. 19(9): 17-31.

26. 24 Aradmehr M, Azhari S, Ahmadi S, Azmodeh E. Relationship between delivery and neonatal factors with healing of episiotomy in primiparous women at Mashhad Omalbanin Hospital in 2013. IJOGI 2016. 19(17): 13-23.

27. 25 Navinejad M, Abedian Z, Asili J, Esmaili H, Watanchi A. Investigating the effect of alpha ointment (Fandermol) on episiotomy wound healing in primiparous women. J of Midwifery and Infertility of Iran 2016. 20(4):58-65.

28. 26 Vahdatpour B, Baradaran Mahdavi S, Arzaghi S, Haghighat S, Sadegh MM. The Effectiveness of Elaeagnus Angustifolia Versus Curcumin in Osteoarthritis of the Knee - A Triple-Blind Randomized Clinical Trial. J Isfahan Med Sch 2022. 40(681): 563-70.

29. 27 Reda M. Effect of Olive Oil, Lavender Oil and Placebo on Pain Intensity and Healing of Episiotomy in Women. TSNJ 2021. 20(1): 47-63. [DOI:10.21608/tsnj.2021.168849]

30. 28 Amani N, Khairkhah M, Mojab F and Haqqani, H. investigation of the effect of hemp ointment on episiotomy wound pain intensity. National Student Conference of Medicinal Plants and Complementary Medicine Sabzvar 2017.

31. 29 Shayan A, Sourinezhad H, Barzegar F, Ahmadinia H, Masoumi Z, Moradkhani Sh and Refaei M, The Effect of Olive Oil and Honey Combination on Episiotomy Wound Healing and Pain Relief: A Randomized Clinical Trial, Curr. Women's Health Rev 2020. 16(2) . [DOI:10.2174/1573404816666200123111718]

32. 30 TageldinAbdelhafiz A, Abdelmoneim J, Khoder M. Topical Bee Honey for Severely Infected Perineal and Episiotomy Wounds. Acta HealthMedica 2018. 3(1):10-12 [DOI:10.19082/ah240]

33. 31 Heidari T, Roozbahani N, Amiri Farahani L, Attarha M, Akbari Torkestani N, Jamilian M, Bekhradi R. Does Iranian Astragalus gossypinus honey assist in healing caesarean wounds and scars? Eur. J. Integr. Med 2013. 5(3): 226-233 [DOI:10.1016/j.eujim.2013.01.005]

34. 32 Masumi Z, Keramat A, Haji Aghaii R. Systematic review of the efficacy

35. of medicinal plants on pain after cutting cesarean section and perineal

36. pain. J Med Plant Res 2011. 4(10): 1-12. [persian]