Essential oils for healing and/or preventing infection of surgical wounds: a systematic review

Nascimento, Ariane Souza do; Tamiasso, Renata Souza Souto; Morais, Sabrina Ferreira Monteiro; Rizzo Gnatta, Juliana; Turrini, Ruth Natalia Teresa; Calache, Ana Lucia Siqueira Costa; de Brito Poveda, Vanessa

doi:10.1590/1980-220X-REEUSP-2021-0442en

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REVIEW • Rev. esc. enferm. USP 56 (spe) • 2022 • https://doi.org/10.1590/1980-220X-REEUSP-2021-0442en copy

Essential oils for healing and/or preventing infection of surgical wounds: a systematic review

Aceites esenciales para la cicatrización y/o prevención de infecciones de heridas quirúrgicas: una revisión sistemática

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To analyze the evidence available in the literature on the use of essential oils for healing and/or preventing infection in surgical wounds.

Method:

Systematic review according to the JBI model and PRISMA statement. The search was carried out in November/2020 and updated in December/2021, using descriptors and keywords, in the CINAHL, LILACS, CENTRAL, EMBASE, PUBMED, Scopus, and Web of Science databases. The quality of the evidence was assessed using the JBI critical appraisal tool for randomized controlled trials.

Results:

Five publications were included. Three studies evaluated healing and the presence of infection after episiotomy using the Redness-Edema-Ecchymosis-Discharge-Approximation (REEDA) scale; one study evaluated healing after periodontal surgery using the plaque index and Modified Gingival Index; the other four studies considered the presence of infection after episiotomy. Most studies used lavender oil, associated or not with other oils (80%). Two studies showed an improvement in healing. The infection outcome, although mentioned by 60% of studies, was not assessed as a primary outcome.

Conclusion:

The promising efficacy of essential oils, especially lavender, was verified in the healing of surgical wounds, especially in episiotomies.

DESCRIPTORS
Aromatherapy; Oils Volatile; Lavandula; Surgical Wound; Surgical Wound Infection; Wound Healing

Author/Year	Population	n	Intervention	Outcome/tool	Outcome
Behmanesh et al., 2011 (¹⁸18. Behmanesh F, Tofighi M, Delavar MA, Zeinalzadeh M, Moghadamnia AA, Khafri S. A clinical trial to compare the effectiveness of lavender essential oil and olive oil at healing postpartum mother’s perinea. Healthmed. 2011;5(6):1512-6.)	Primiparous	89	Group 1: 2% Lavender EO in Olive Oil (10 drops: 5 L warm water) Group 2: Olive Oil (10 drops: 5 L warm water) G3 (control): distilled water Sitz bath 2x/day for 10 days Professional responsible for outcome assessment: obstetrician	Pain – VAS Cicatrization – REEDA	– Significant pain reduction in the three groups – Improved cicatrization (p < 0.05) in Group 1 and Group 2 compared to Group 3
Dale, Cornwell, 1993 (¹⁹19. Dale A, Cornwell S. The role of lavender oil in relieving perineal discomfort following childbirth: a blind randomized clinical trial. J Adv Nurs. 1994;19(1):89-96. DOI: http://doi.wiley.com/10.1111/j.1365-2648.1994.tb01056.x http://doi.wiley.com/10.1111/j.1365-2648... )	Vaginal delivery	635	Group 1: 100% lavender EO Group 2: synthetic lavender oil Group 3 (aromatic placebo): 2-methyl, 3-isobutyl pyrazine diluted in 10^-10 distilled water Daily sitz bath for 10 days Professional responsible for outcome assessment: obstetrician	Perineal discomfort – VAS Mood – VAS	– No difference was found between groups regarding perineal discomfort or mood for the three groups (p > 0.05)
Sheikhan et al., 2012 (²⁰20. Sheikhan F, Jahdi F, Khoei EM, Shamsalizadeh N, Sheikhan M, Haghani H. Episiotomy pain relief: Use of Lavender oil essence in primiparous Iranian women. Complement Ther Clin Pract [Internet]. 2012 [cited 2021 Dec 10];18(1):66-70. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1744388111000223 https://linkinghub.elsevier.com/retrieve... )	Primiparous	60	Group 1: 100% lavender EO (0.25 mL EO: 5 L water) Group 2: 10% Betadine (10 mL Betadine: 4 L water) Sitz bath 2x/day for 5 days Professional responsible for the outcome assessment: not mentioned	Cicatrization – REEDA Perineal discomfort – VAS	– No difference in cicatrization was found between the groups (p > 0.05) – Lavender reduced pain and there was less use of analgesics (p < 0.05)
Katsaros et al., 2020 (²¹21. Katsaros T, Mayer E, Palaiologou A, Romero-Bustillos M, Evans GH, Lallier TE, et al. Effect of different concentrations of commercially available mouthwashes on wound healing following periodontal surgery: a randomized controlled clinical trial. Clin Oral Investig [Internet]. 2020 [cited 2021 Dec 10];24(10):3587-95. Available from: http://link.springer.com/10.1007/s00784-020-03232-5 http://link.springer.com/10.1007/s00784-... )	Periodontal surgery patients	80	Group 1: EO (thymol + eucalyptol + menthol) Group 2: chlorhexidine (CHX) Group 3: 10% EO Group 4: 5% CHX Group 5: water Mouthwash 2x/day, exclusive for 2 weeks, brushing introduced in the 3^rd week Professional responsible for the outcome assessment: dentist	Plaque index (PI) and Modified Gingival Index (MGI) Epithelization	– Modified Gingival Index (p > 0.05) – 1^st and 2^nd evaluation equal plaque index between groups (p > 0.05). 3^rd evaluation Group 2 CHX better than Group 5 water (p < 0.05). In the 1^st evaluation Group 2 CHX all wounds open, in the 3^rd evaluation all groups were equal (p > 0.05).
Marzouk et al., 2014 (²²22. Marzouk T, Barakat R, Ragab A, Badria F, Badawy A. Lavender-thymol as a new topical aromatherapy preparation for episiotomy: A randomised clinical trial. J Obstet Gynaecol (Lahore) [Internet]. 2015 [cited 2021 Dec 10];35(5):472-5. Available from: http://www.tandfonline.com/doi/full/10.3109/01443615.2014.970522 http://www.tandfonline.com/doi/full/10.3... )	Primiparous	69	Group 1: Thymol EO + 2% lavender diluted in jojoba oil (7 drops: 4 L water) Group 2: routine solution (10 mL 0.9% saline solution: 4 L water) Local hygiene 2x/day for 7 days Professional responsible for the outcome assessment: not mentioned	Pain – VAS Dyspareunia – VAS Cicatrization – REEDA	– Group 1 EO better cicatrization, less pain at episiotomy and dyspareunia (p < 0.05) than Group 2

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Ariane Souza do Nascimento Avenida Doutor Enéas de Carvalho Aguiar 419, Cerqueira César 05403-000 – São Paulo, SP, Brazil ariane.nascimento@usp.br