2025, Vol. 8, Issue 2, Part A

Background: Episiotomy is common in vaginal births and often results in short-term perineal pain, edema, and impaired mobility. Warm, moist compresses during and after childbirth reduce severe perineal trauma and short-term pain, but optimal topical adjuncts remain underexplored. Neem (Azadirachta indica) has long-standing use in South Asian postpartum care for its anti-inflammatory, antimicrobial, and wound-healing properties. However, the specific concept of “neem damp heat compression” (a warm, moist compress infused with neem decoction or extract) for episiotomy-related vulval edema and pain lacks formal delineation and clinical testing.
Objective: To clarify and critically appraise the concept of neem damp heat compression for post-episiotomy care, integrating evidence on (i) perineal heat therapies and (ii) topical neem in wound care, and to propose a novel, evaluable care pathway.
Methods: Concept analysis (Walker & Avant-style) synthesizing literature from PubMed/PMC/Scopus /PKP/BMJ guidance spaces on perineal heat and neem topical therapeutics. We defined defining attributes, antecedents, consequences, surrogate endpoints, and empirical referents, and mapped a research-to-practice framework. We also outline a pragmatic trial design and a minimum viable formulation standard for clinical use.
Results: Warm moist perineal compresses reduce severe perineal tears and short-term pain; dry heat has also improved early episiotomy wound healing. Neem shows anti-inflammatory, antimicrobial, and pro-healing effects in preclinical and early clinical wound contexts. Synthesized, these support a plausible, testable intervention: neem-infused warm compresses may attenuate edema, lower pain scores, and promote wound healing while maintaining safety. We identify core attributes (temperature 40-42 °C; moist heat duration 10-20 min; standardized neem decoction/extract concentration; sterile delivery) and propose outcome/stability indicators.
Conclusions: Neem damp heat compression is a promising integrative nursing intervention meriting rigorous evaluation. We present a translational blueprint (formulation, safety screening, and a pilot RCT) to generate high-quality evidence for postpartum nursing practice.