Effectiveness of Dry Heat Versus Moist Heat Modalities on Pain Intensity and Wound Healing of Episiotomies Among Postnatal Women: A Systematic Review and Meta-Analysis.

ABSTRACT

OBJECTIVES: Comparison of the effects of dry heat versus moist heat therapy modalities on the intensity of pain and wound healing of episiotomies among postnatal women. DESIGN: A Systematic review and meta-analysis of controlled trials. DATA SOURCES Six databases searched for original articles using relevant keywords until September 10, 2023, without time or language restrictions. REVIEW/ANALYSIS METHODS: All analyses employed Comprehensive Meta-Analysis (CMA) V.2. The measure of heterogeneity was computed using Cochran's Q-value. The I2 index was employed to quantitatively demonstrate heterogeneity. Statistical significance was reported for P-values <0.05 and I2>50%. RESULTS: Four quasi-experimental and three randomized controlled trials (RCTs) studies with moderate-to-good quality evidence met inclusion criteria. On the third to fifth day after the intervention in the dry heat group, the amount of pain was significantly lower than in the group that used moist heat [MD (95% CI) =-1.395 (-2.374, -0.416), P=0.005]. The use of a hair dryer significantly reduced pain (P=0.029), but an infrared lamp did not significantly reduce pain compared to moist heat (P=0.064). As compared to the moist heat group, the women using dry heat experienced better wound healing to the extent of 2.002 units of the REEDA (Redness, Edema, Ecchymosis, Discharge, Approximation) scale, which was statistically significant [MD (95% CI) = -2.002 (-2.785, -1.219), P<0.001]. CONCLUSION: Compared to sitz baths, dry heat reduced pain and improved episiotomy site healing in postnatal women. Therefore, dry heat, especially hair dryers, is suggested as a non-pharmacological strategy inside maternity hospitals, but additional targeted, high-quality trials are needed.