Perawatan Luka Perineum dan Proses Penyembuhan Fisiologis pada Ibu Postpartum: Tinjauan Literatur
DOI:
https://doi.org/10.52120/tcpqj234Kata Kunci:
ibu postpartum, luka perineum, perawatan luka, penyembuhan fisiologis, episiotomiAbstrak
Luka perineum merupakan trauma jaringan akibat robekan spontan atau episiotomi pada persalinan pervaginam yang dapat menimbulkan nyeri, edema, infeksi, dan keterlambatan penyembuhan. Penelitian ini bertujuan menganalisis berbagai metode perawatan luka perineum serta keterkaitannya dengan proses penyembuhan fisiologis pada ibu postpartum. Metode yang digunakan adalah literature review dengan penelusuran artikel melalui PubMed, ScienceDirect, Google Scholar, Scopus, Cochrane Library, dan Garuda. Artikel dipilih berdasarkan kesesuaian topik, ketersediaan teks lengkap, dan pelaporan hasil berupa skor REEDA, nyeri, edema, infeksi, dehisensi, atau lama penyembuhan luka. Hasil telaah menunjukkan bahwa perawatan kebersihan perineum, kompres dingin, sitz bath, pemberian analgesik, teknik penjahitan yang tepat, edukasi, serta pemenuhan nutrisi tinggi protein dapat mendukung penyembuhan luka. Secara fisiologis, metode tersebut bekerja melalui pengurangan kontaminasi mikroorganisme, vasokonstriksi atau vasodilatasi lokal, penurunan inflamasi, peningkatan sirkulasi, proliferasi fibroblas, epitelisasi, angiogenesis, dan sintesis kolagen. Terapi pendamping seperti madu, aloe vera, calendula, daun binahong, daun sirih, ikan gabus, dan putih telur juga menunjukkan potensi mempercepat penyembuhan, tetapi hasil penelitiannya masih bervariasi. Disimpulkan bahwa perawatan luka perineum yang efektif memerlukan kombinasi kebersihan luka, pengendalian nyeri, pemenuhan nutrisi, edukasi, serta pemantauan tanda infeksi dan dehisensi. Terapi komplementer dapat digunakan sebagai pendamping, tetapi tidak menggantikan perawatan standar dan pemeriksaan tenaga kesehatan.
Unduhan
Referensi
Alvarenga, M. B., Francisco, A. A., de Oliveira, S. M. J. V., da Silva, F. M. B., Shimoda, G. T., & Damiani, L. P. (2015). Episiotomy healing assessment: Redness, oedema, ecchymosis, discharge, approximation (REEDA) scale reliability. Revista Latino-Americana de Enfermagem, 23(1), 162–168. doi:10.1590/0104-1169.3633.2538.
Aromataris, E., & Munn, Z. (Eds.). (2020). JBI manual for evidence synthesis. Joanna Briggs Institute. doi:10.46658/JBIMES-20-01.
Bramer, W. M., de Jonge, G. B., Rethlefsen, M. L., Mast, F., & Kleijnen, J. (2018). A systematic approach to searching: An efficient and complete method to develop literature searches. Journal of the Medical Library Association, 106(4), 531–541. doi:10.5195/jmla.2018.283.
Campos, A. C. L., Groth, A. K., & Branco, A. B. (2008). Assessment and nutritional aspects of wound healing. Current Opinion in Clinical Nutrition and Metabolic Care, 11(3), 281–288. doi:10.1097/MCO.0b013e3282fbd35a.
Davidson, N. (1974). REEDA: Evaluating postpartum healing. Journal of Nurse-Midwifery, 19(2), 6–8. doi:10.1111/j.1542-2011.1974.tb00384.x.
De Angelis, C., Di Stadio, A., Vitale, S., Saccone, G., De Angelis, M. C., Zizolfi, B., & Di Spiezio Sardo, A. (2022). Use of calendula ointment after episiotomy: A randomized clinical trial. The Journal of Maternal-Fetal & Neonatal Medicine, 35(10), 1860–1864. doi:10.1080/14767058.2020.1770219.
Defante, M. L. R., de Souza, K., Oliveira, J. A., Salgado, A. S. I., de Oliveira, F. R., & Cardoso, F. S. (2025). Continuous versus interrupted suturing for second-degree perineal tears and episiotomies: A meta-analysis of randomized trials. European Journal of Obstetrics & Gynecology and Reproductive Biology, 314, 114722. doi:10.1016/j.ejogrb.2025.114722.
East, C. E., Dorward, E. D. F., Whale, R. E., & Liu, J. (2020). Local cooling for relieving pain from perineal trauma sustained during childbirth. Cochrane Database of Systematic Reviews, 2020(10), CD006304. doi:10.1002/14651858.CD006304.pub4.
Eghdampour, F., Jahdie, F., Kheyrkhah, M., Taghizadeh, M., Naghizadeh, S., & Hagani, H. (2013). The impact of Aloe vera and Calendula on perineal healing after episiotomy in primiparous women: A randomized clinical trial. Journal of Caring Sciences, 2(4), 279–286. doi:10.5681/jcs.2013.033.
Eriksen, M. B., & Frandsen, T. F. (2018). The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: A systematic review. Journal of the Medical Library Association, 106(4), 420–431. doi:10.5195/jmla.2018.345.
Gondim, E. J. L., Nascimento, S. L., Gaitero, M. V. C., Mira, T. A. A., & Surita, F. G. (2025). Non-pharmacological interventions for perineal trauma in the postpartum period: A scoping review. Midwifery, 144, 104341. doi:10.1016/j.midw.2025.104341.
Guo, S., & DiPietro, L. A. (2010). Factors affecting wound healing. Journal of Dental Research, 89(3), 219–229. doi:10.1177/0022034509359125.
Hapsari, R., & Tjandrawinata, R. R. (2025). Nutritional composition and action mechanism of Channa striata meat in wound healing: A systematic review. Narra J, 5(3), e2903. doi:10.52225/narra.v5i3.2903.
Hill, P. D. (1990). Psychometric properties of the REEDA. Journal of Nurse-Midwifery, 35(3), 162–165. doi:10.1016/0091-2182(90)90166-3.
Jones, K., Webb, S., Manresa, M., Hodgetts-Morton, V., & Morris, R. K. (2019). The incidence of wound infection and dehiscence following childbirth-related perineal trauma: A systematic review of the evidence. European Journal of Obstetrics & Gynecology and Reproductive Biology, 240, 1–8. doi:10.1016/j.ejogrb.2019.05.038.
Man, R., Le Vance, J., Popa, Y., Wilson, D., Tohill, S., Maltby, J., Hodgetts Morton, V., Morris, R. K., & CHAPTER Group. (2026). Healing-assessment tools for perineal and cesarean section wounds in postpartum women: A scoping review. Acta Obstetricia et Gynecologica Scandinavica, 105(1), 18–29. doi:10.1111/aogs.70089.
Miladiyah, I., & Prabowo, B. R. (2012). Ethanolic extract of Anredera cordifolia (Ten.) Steenis leaves improved wound healing in guinea pigs. Universa Medicina, 31(1), 4–11.
Munn, Z., Peters, M. D. J., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Medical Research Methodology, 18, 143. doi:10.1186/s12874-018-0611-x.
National Institute for Health and Care Excellence. (2021). Postnatal care: NICE guideline NG194. NICE. Updated June 9, 2026.
Nayaka, N. M. D. M. W., Sasadara, M. M. V., Sanjaya, D. A., Yuda, P. E. S. K., Dewi, N. L. K. A. A., Cahyaningsih, E., & Hartati, R. (2021). Piper betle (L.): Recent review of antibacterial and antifungal properties, safety profiles, and commercial applications. Molecules, 26(8), 2321. doi:10.3390/molecules26082321.
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., McGuinness, L. A., ... Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. doi:10.1136/bmj.n71.
Popay, J., Roberts, H., Sowden, A., Petticrew, M., Arai, L., Rodgers, M., Britten, N., Roen, K., & Duffy, S. (2006). Guidance on the conduct of narrative synthesis in systematic reviews: A product from the ESRC Methods Programme. Lancaster University.
Ramler, D., & Roberts, J. (1986). A comparison of cold and warm sitz baths for relief of postpartum perineal pain. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 15(6), 471–474. doi:10.1111/j.1552-6909.1986.tb01426.x.
Saad, J., & Painter, C. (2023). Management of postpartum perineal wound complications. Current Opinion in Obstetrics & Gynecology, 35(6), 505–509. doi:10.1097/GCO.0000000000000906.
Schaap, I. S., Lardenoije, C. M. J. G., van Riel, S. J. J. M., & Cremers, N. A. J. (2025). The efficacy of honey for the treatment of perineal wounds following vaginal birth: A narrative review. Pharmaceuticals, 18(2), 182. doi:10.3390/ph18020182.
Vanzella, J. S. S., Fitz, F. F., Castro, R. A., Scudeller, T. T., & Bortolini, M. A. T. (2026). Infrared and laser for pain and healing of postpartum perineal injuries: A systematic review and meta-analysis. International Urogynecology Journal. Advance online publication. doi:10.1007/s00192-026-06601-y.
White, C., & Atchan, M. (2022). Postpartum management of perineal injury: A critical narrative review of level 1 evidence. Midwifery, 112, 103410. doi:10.1016/j.midw.2022.103410.
Wilkinson, H. N., & Hardman, M. J. (2020). Wound healing: Cellular mechanisms and pathological outcomes. Open Biology, 10(9), 200223. doi:10.1098/rsob.200223.
World Health Organization. (2022). WHO recommendations on maternal and newborn care for a positive postnatal experience. World Health Organization.
Yilmaz, A. C., & Aygin, D. (2020). Honey dressing in wound treatment: A systematic review. Complementary Therapies in Medicine, 51, 102388. doi:10.1016/j.ctim.2020.102388.
