Brezeanu Dragos, Brezeanu Ana-Maria, Chirila Sergiu Ioachim, Tica Vlad
Faculty of Medicine, Ovidius University of Constanta, 900573 Constanta, Romania.
County Clinical Emergency Hospital "Sf. Ap. Andrei", 900591 Constanta, Romania.
Healthcare (Basel). 2025 Jul 1;13(13):1581. doi: 10.3390/healthcare13131581.
Episiotomy-related morbidity remains a substantial challenge in postpartum recovery, often affecting maternal quality of life. Given the crucial role of local microbiota and wound environment in perineal healing, intravaginal lactic acid gel emerges as a promising adjunctive therapy. To evaluate the effectiveness and safety of intravaginal lactic acid gel (Canesbalance, Bayer) in enhancing scar healing and reducing pain following mediolateral episiotomy. In this single-center randomized controlled trial, 100 postpartum women with mediolateral episiotomy were allocated to either a treatment group receiving intravaginal lactic acid gel (Canesbalance, Bayer) or a standard care group. Scar healing was assessed at 7 and 40 days postpartum using POSAS, VAS, and NRS scores; hematological parameters were also monitored. The lactic acid gel group demonstrated significantly greater reductions in scar severity and pain scores over time ( < 0.05), with no adverse hematological effects. Effect sizes (Cohen's d) were moderate to high for scar healing (d = 0.76) and pain reduction (VAS: d = 0.83; NRS: d = 0.79), indicating clinical relevance beyond statistical significance. Intravaginal application of lactic acid gel may offer a safe and effective strategy to enhance perineal wound healing and pain relief after episiotomy. Further large-scale studies are warranted to validate these promising findings and explore underlying mechanisms.
会阴切开术相关的发病率仍然是产后恢复中的一个重大挑战，常常影响产妇的生活质量。鉴于局部微生物群和伤口环境在会阴愈合中的关键作用，阴道内乳酸凝胶成为一种有前景的辅助治疗方法。为了评估阴道内乳酸凝胶（Canesbalance，拜耳公司）在促进侧切会阴切开术后瘢痕愈合和减轻疼痛方面的有效性和安全性。在这项单中心随机对照试验中，100名接受侧切会阴切开术的产后妇女被分配到接受阴道内乳酸凝胶（Canesbalance，拜耳公司）的治疗组或标准护理组。在产后7天和40天时，使用POSAS、VAS和NRS评分评估瘢痕愈合情况；还监测血液学参数。乳酸凝胶组随着时间的推移，瘢痕严重程度和疼痛评分显著降低（<0.05），且无不良血液学影响。对于瘢痕愈合（d = 0.76）和疼痛减轻（VAS：d = 0.83；NRS：d = 0.79），效应量（科恩d值）为中度到高度，表明除了统计学意义外还具有临床相关性。阴道内应用乳酸凝胶可能为促进会阴切开术后会阴伤口愈合和减轻疼痛提供一种安全有效的策略。有必要进行进一步的大规模研究来验证这些有前景的发现并探索潜在机制。
