title: Ananas comosus Effect on Perineal Pain and Wound Healing After Episiotomy: A Randomized Double-Blind Placebo-Controlled Clinical Trial.
abstract: BACKGROUND
  Ananas comosus has long been used for medical purposes. Currently, we are experiencing an unprecedented interest in the use of complementary medicine as well as a growing attention to traditional products such as bromelain for wound healing and reducing pain.
  
  
  OBJECTIVE
  The aim of this study was to determine the effect of oral bromelain on perineal pain and wound healing after episiotomy in primiparous women.
  
  
  METHODS
  In this double-blind placebo-controlled clinical trial, 82 primiparous women fulfilling the inclusion criteria received bromelain or placebo randomly. Participants were given three tablets, three times a day for six successive days. The initial dose was given 2 hours after delivery. Episiotomy pain was measured using VAS scale before the initial dose, as well as on the 1st hour and on the 3rd, 7th and 14th days after the initial dose. Wound healing was measured using REEDA scale on the 3rd, 7th and 14th days after delivery.
  
  
  RESULTS
  Episiotomy pain significantly reduced in bromelain group compared with the placebo group (P < 0.05) and wound healing was faster in bromelain group compared with the placebo group (P < 0.05) on follow-up days.
  
  
  CONCLUSIONS
  The results showed the effectiveness of bromelain on episiotomy pain and wound healing. Therefore, it is suggested to use bromelain in postoperative stage to improve wound healing and reduce pain.
authors.affiliation: Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Department of Midwifery, Toyserkan Branch, Islamic Azad University, Toyserkan, IR Iran.
authors.forename: Samira
authors.initials: S
authors.lastname: Golezar
keywords: Bromelains; Episiotomy; Pain; Wound Healing