The therapeutic effect of curcumin on episiotomy wound healing: A systematic review and meta-analysis

Background: Pain and infection after episiotomy are common challenges that hinder maternal recovery. Curcumin, with anti-inflammatory and antimicrobial properties, is a potential therapeutic agent, but its efficacy for episiotomy healing is unproven. Objectives: This study aimed to systematically evaluate the effect of topical curcumin on episiotomy wound healing. Methods: Databases including Google Scholar, PubMed, Cochrane, Web of Sciences, Scopus, Embase, ProQuest, SID, and Magiran were searched until March 11, 2025, using MeSH and Emtree keywords. Risk of bias was assessed with Cochrane RoB 1 and ROBINS-I tools. A random-effects meta-analysis calculated the mean difference (MD) with 95% CIs. Heterogeneity was quantified by the I² statistic, and evidence certainty was assessed using the GRADE framework. Results: The search retrieved 2531 articles; after removing duplicates and ineligible studies, four articles were included in the systematic review. Meta-analysis of three studies showed no statistically significant effect of curcumin on perineal wound healing compared to controls (MD = -1.02; 95% CI: -2.39 to 0.35, P = 0.14), with substantial heterogeneity (I² = 83%, p = 0.003). Evidence quality was very low. Conclusion: Based on a limited number of studies, available evidence is of very low quality and does not demonstrate a statistically significant effect of curcumin on episiotomy wound healing. Due to the scarcity and low quality of evidence, firm conclusions cannot be drawn. This review underscores a critical evidence gap, highlighting the urgent need for high-quality randomized