Comparative Effectiveness Of Aswagandhadi Malahara And Jatyadi Taila In Accelerated Wound Healing Activity Of Episiotomy: A Randomized Clinical Study

Abstract

Episiotomy, a surgically planned incision on the perineum performed during the second stage of labor, is categorized in Ayurveda as Agantuja Chinna Vrana (exogenous incised wound). The resulting postpartum wound frequently leads to significant maternal morbidity, characterized by intense pain, localized inflammation, and the high risk of infection dueence to contamination from vaginal and fecal matter. There is a pronounced clinical necessity for topical agents that possess potent Vrana Shodhana (cleansing) and Vrana Ropana (healing) properties while simultaneously offering protection and sustained analgesic action.   

Objective -This prospective, randomized, comparative clinical study was undertaken to scientifically evaluate and compare the therapeutic efficacy of two distinct classical Ayurvedic wound healing formulations—Aswagandhadi Malahara (AM), an ointment-based preparation, and Jatyadi Taila (JT), an oil-based formulation—in managing the wound healing activity of episiotomy.

Methods-A total of 30 postnatal women with sutured episiotomy wounds were enrolled and randomly assigned to one of two groups (N=15 each): Group A (Aswagandhadi Malahara application) and Group B (Jatyadi Taila application). Both treatments were administered twice daily for a period of 7 days, with follow-up continuing until Day 15. Efficacy assessment relied on objective and subjective parameters: pain intensity was measured using the Defense and Veterans Pain Rating Scale (DVPRS), and wound healing dynamics were tracked using the standardized REEDA scale (Redness, Edema, Ecchymosis, Discharge, Approximation). Statistical analysis employed non-parametric methods, including Friedman's test for overall temporal change, Wilcoxon Signed Rank test with Bonferroni correction for paired comparisons, and the Mann-Whitney U test for comparative analysis between groups.  

Results-Both Aswagandhadi Malahara and Jatyadi Taila demonstrated exceptional therapeutic efficacy. Within-group analysis showed a highly significant reduction across all major subjective and objective parameters, including pain (DVPRS, χ2>30.550, p<.001), redness (χ2=38.28, p<.001), and tenderness (χ2>37.500, p<.001) by Day 15. Comparative analysis revealed that Aswagandhadi Malahara offered a statistically significant and transient advantage in the acute phase of healing, specifically reducing Redness (e.g., 3D-7D, p=.002) and Tenderness (all intervals, p<.023) when compared to Jatyadi Taila. The overall rate of complete wound healing was comparable between the two groups (AM: 80%; JT: 86.7%). No Adverse Drug Reactions (ADR) were observed in either cohort.  

Conclusion-Aswagandhadi Malahara and Jatyadi Taila are confirmed as safe, potent, and equally effective topical interventions for accelerated wound healing in postpartum episiotomy care. The superior initial anti-inflammatory and analgesic effect observed with the Malahara formulation supports its preferential use immediately following suturing, leveraging its semi-occlusive base for localized protection and sustained delivery of therapeutic agents. These findings robustly validate the utility of classical Ayurvedic principles in modern obstetric wound management.