Standardised Flavonoid Ointment from Nigella sativa L. for Postpartum Maternal Perineal Wound Care in Central Kalimantan, Indonesia

Background: Perineal wounds remain a postpartum issue, particularly in Central Kalimantan, Indonesia. Prior research showed that approximately 31.7% of perineal wounds remained unhealed by the seventh day, highlighting the need for additional natural and herbal treatments to accelerate healing and prevent complications. Black cumin (Nigella sativa L.) is a medicinal herb rich in flavonoids, which have been scientifically proven to enhance the wound healing process.Objective: To analyse the effects of flavonoids from Nigella sativa (NS) on second-degree perineal wound healing in postpartum women in Central Kalimantan. Methods: A single-blind randomised controlled trial involving 81 participants divided into three groups (15% NS ointment, 10% Povidone-iodine (PI) ointment, and a placebo) was conducted. Each group had 27 participants, and ointments were applied twice daily for seven days. Wound healing was assessed using the redness, oedema (edema), ecchymosis, discharge, and approximation (REEDA) scale on the first, third, and seventh days, and data were analysed using IBM SPSS Statistics v27. Results: NS extract contained 5.253 mg quercetin equivalent (QE)/g flavonoids and exhibited strong antioxidant activity (IC50=19.709 ppm). Significant differences were observed in wound healing among the three treatments (p≤0.001). Cohen’s d showed a large effect (0.8) for NS vs. PI and a very large effect (1.44) for NS vs. the placebo. Wound healing improvements were 96.3% (NS), 81.5% (PI), and 55.6% (placebo). Conclusion: The 15% NS ointment, which is standardised with flavonoids, significantly accelerated perineal wound healing in postpartum women. These findings suggest that this agent may serve as an alternative or complementary treatment to PI, particularly in areas with limited medical access; however, further research is needed to explore its long-term effects, optimal dosage, and potential side effects.