American Journal of Nursing Research, 2013, Vol. 1, No.

1, 43-46
Available online at http://pubs.sciepub.com/ajnr/1/1/7
Science and Education Publishing
DOI:10.12691/ajnr-1-1-7

Effectiveness of Infrared Rays on Wound Healing among

Caesarean Section Mothers at Puducherry
Manju Bala Dash1,*, Sengathir Selvi2
1

Professor in Nursing, MTPG & RIHS, Puducherry, India

2
M.Sc Nursing, MTPG & RIHS
*Corresponding author: manju_narayan@rediffmail.com

Received October 28, 2013; Revised November 28, 2013; Accepted December 08, 2013

Abstract To evaluate the effectiveness of Infrared rays on wound healing and pain level in the experimental
group comparison with control group mothers were conducted at Puducherry, India. Methodology: quantitative
approach and pre- test/ post- test control group design adopted and 100 caesarean section mothers (50 experimental
& 50 control group) were selected by simple random sampling technique. Pretest was done to assess the existing
wound healing & pain level for both group with standard scale (Modified Southampton wound assessment scale
&Numeric pain rating scale). Experimental group received infrared therapy whereas the control group received
routine dressing for twice a day for 3 days. Post-test assessment of wound healing & pain level was done on 5th & 7th
post operative days with the same standard scales. Result and findings: Pre& post-test mean wound healing scores
in experimental group was 2.1 1.446 & 1.26 0.828 respectively with t value 4.365(p<0.05), Similarly the mean
pain level scores was 3.900.303 & 1.940.424 with the t value 28.100(p<0.05) and found statistically significant.
There was a positive correlation between the wound healing and pain level score r = 0.22.

Keywords: infrared, wound healing, caesarean section

Cite This Article: Manju Bala Dash, and Sengathir Selvi, Effectiveness of Infrared Rays on Wound Healing
among Caesarean Section Mothers at Puducherry. American Journal of Nursing Research 1, no. 1 (2013): 43-46.
doi: 10.12691/ajnr-1-1-7.

1. Introduction
Pregnancy and child birth are special events in
womens lives. Naturally, expectant mothers spend a lot of
time thinking about how they will give birth. Although
most people believe that a vaginal birth is the best way to
deliver, sometimes a Caesarean section (CS) cannot be
avoided [1,2,3].
Caesarean birth is used most often as a prophylactic
measures, to alleviate problem of birth such as cephalo
pelvic disproportion , failure to progress in labour or fetal
distress. A major concern in maternal and child health
nursing is the increasing number of caesarean birth being
performed annually [4,5].
In India, the incidence of primary caesarean birth is
about 30.2% or onethird of births (National Vital
Statistics System, 2008). The majority of the states are
within the WHO specified range of 5 to 15% Caesarean
section, among that, five states are above the range and 12
states below the specified range. This rate ranged between
26 % and 2%.The prevalence of Caesarean section is
generally more in the southern states and in Pondicherry it
is around 31.93% in rural and 39.92% in the urban area
[6,7,8].
Post caesarean wound infection is not only a leading
cause of prolonged hospital stay but a major cause of the
widespread aversion to caesarean delivery in developing

countries. [9]. Immediate management is essential to

decrease the chance of infection, length of the hospital
stay and to return for normal function. Infra red radiation
is one of the modalities to treat the pain and wound.
Heat transmission with IR radiation is governed by
inverse square law, it state that the intensity of radiation
varies inversely with the square of the distance between
the source of radiation &the skin. Intensity of the radiation
is reduced; if the distance between the source & the target
is increased & vice versa. The duration of the exposure
should be 15 to 20 minutes once or twice a day. The
treatment commence with the IR source placed at distance
of 30 to 36 from the surface being treated [10,11,12,13].
Infrared Rays has therapeutic effect of increasing the
blood supply and relieving the Pain. This will increase the
supply of oxygen and nutrient available to the tissues
accelerate the removal of the waste products and help to
bring about the resolution of inflammation. When the heat
is mild, the relief of pain is probably due to the sedative
effect on the superficial sensory nerve endings. It is also
helping achieve muscular relaxation and for the relief of
muscle spasm associated with injury or inflammation
[14,15,16]. Infrared rays also have the physiological effect
on cutaneous vasodilation due to liberation of chemical
vasodilators, histamine and similar substance, as well as
possible direct effect on the blood vessels. [20] So the
infra red radiation is considered as a choice of Electro
Therapy Modality for the caesarean section mothers.

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American Journal of Nursing Research

1.1. Objectives
To evaluate the effectiveness of Infrared rays on
wound healing and pain level in the experimental
group comparison with control group.
To correlate the level of pain with the Wound healing.
Assumption: Infrared ray therapy may have an effect
on wound healing and reduces the intensity of pain among
the caesarean section mothers.

1.2. Hypothesis
H1: There will be a significant difference between the
pre &post tests wound healing & pain level scores among
the control and experimental group.

2. Methodology
2.1. Research Approach & Design
A Quantitative approach& True experimental - Pretest/post-test control group design was adopted to fulfill
the aim of this study. The sample for the study comprises
of all Caesarean Section mothers and the sample size was
100 subjects, who underwent caesarean section of which
50 in the control group and 50 in the experimental group.

2.2. Criteria for Sample Selection

2.2.1. Inclusion Criteria
Mother who are willing to participate
Mothers are in 3rdpost operative day
2.2.2. Exclusion Criteria
Post operative mothers with any complication or
complication to baby of the mother during the study
period.( other than pregnancy induced hypertension
and anemia).
Simple Random sampling technique and it is used for
the present study. Hundred mothers (50 in experimental
and 50 in control group) were selected randomly by even
and odd numbers with the help of lot method. The tool has
two section A & section B, further the section A has two
parts for collecting demographic & obstetric variables of
mothers. Section B has two parts for assessing the wound
healing and pain level of caesarean section by Modified
Southampton Wound Assessment & Numeric Pain Rating
Scale [17,18,19].
Table 1. The wound grading was recorded and information about
was regarded in four categories
Grade
Wound healing status
A
Normal healing
B
Minor complication
C
Wound infection
D
Major Hematoma

The most common pain assessment tools are verbal self

report instruments such as the 0-10 Numeric Pain Rating
Scale. Patients were asked to indicate the intensity of
current, best, and worst levels of pain using an 10-point
scale ranging from 0 (none) to 10 (severe pain imaginable)
The average of the 4 ratings was used to represent the
patients level of pain.

SCORE
0
1-3
4-6
7-10

Table 2. The score will be as follows

PAIN LEVEL
PERCENTAGE
No Pain
100%
Mild Pain (nagging, annoying,
90- 70%
interfering little with ADLs)
Moderate Pain (interferes significantly
60-40%
with ADLs)
-SeverePain (disabling; unable to
30-0%
perform ADLs)

The tool was standardized but it was validated by

submitting to experts and the modifications were
incorporated in the final preparation of the tool. Inter rater
method was used to determine the reliability and the r
value is 0.8 considered reliability of the tool.

2.3. Data Collection Procedure

Infrared ray therapy for an Experimental group was
started on 3rd postoperative day of caesarean section. The
3rdpost operative day wound assessment was considered as
pre test .Only the surgical site was exposed to the
infrared rays and the other area was draped. A sterile
dressing was done before the exposure. The mothers were
made into side lying position at a 45 degree angle to the
infrared rays. Eye pad was given to protect their eyes from
retinal damage due to infrared rays. Infrared ray therapy
was given over the caesarean wound for 30 minutes
duration, twice a day, for 3 consecutive days (3rd,
4th&5thpost operative days). The irradiation distance was
about 50 cm from the incision site. After exposure, the
wound healing & pain level was assessed on 5th &7thpost
operative day with Southampton wound assessment and
numeric pain rating scale respectively. The 5th and 7thpost
operative day wound healing & pain level assessment was
considered as post test.
Similarly the Control group was received sterile
dressing on 3rd postoperative day of caesarean section.
The sterile dressing was done twice a day for 3consecutive
days (3rd, 4th &5thpost operative days). After dressing, the
wound was assessed on 5th &7thpost operative days with
Southampton Wound Assessment and Numeric Pain
Rating Scale. The 5th and 7thpost operative day wound
assessment was considered as post test. Schedule for data
collection was shown in the Appendices.

2.4. Result and Findings

The demographic findings shows that majority
26(52%),28(56%) subjects were under the age group of
21-25 years in the control and experimental group
respectively, 38(76%), subjects in control and
experimental group had primary and secondary level of
education, and 49(98%) subjects in control group & all
subjects 50(100%) in experimental had less than Rs 5000
family income per month.
The 5th day post test mean wound healing scores were 2
1.4 & 1.38 0.987 for the control & experimental group
respectively, the calculate t value is 2.559 shows that the
p value (0.12) was statistically not significant though the
mean wound healing scores of the experimental group was
less compare to control group.
On 7th day post test mean wound healing scores were
1.86 1.325 &1.26 0.828 for the control &
experimental group respectively. The calculated t value
is 2.715 shows that the p value (0.008) was statistically

American Journal of Nursing Research

significant in the experimental group in compare to the

control group (Figure 1).
Similarly the 5th day post tests mean pain scores was
3.08 0.528 & 2.68 0.551 for control & experimental
group respectively. The calculated t value 3.705 shows
the (p<0.000) was statistically significant. Further the post
test mean pain scores (7th day) 2.12 0.435 & 1.94
0.424 for control and experimental group respectively.
The calculated t value is 2.094 with p value (0.39) is
statistically significant (Figure 2).

45

Therefore it was inferred that the infrared therapy was

effective in improving the wound healing as well as
reducing the pain level among the subjects in experimental
group.
Table 3. Highlights that there was highly significant
difference found between the post tests wound healing
scores of experimental group mothers, the calculated f
value shows 6.957 with p value 0.001(p<0.001) ***.

Figure 1. Effectiveness of Post tests (5th& 7th day) wound healing scores among the control &experimental group

Figure 2. Effectiveness of Post tests (5th& 7th day) pain level scores among the control &experimental group
Table 3. ANOVA for effectiveness of the post tests wound healing scores in the experimental group
Level of significance
Post test Wound healing scores

Mean

SD
F value &p value

Pre- test 3th day

2.10

th

H1 is accepted.

1.446

Post test on 5 day

1.38

0.987

Post test on 7th day

1.26

0.828

6.957
0.001*** S

***p<0.001, S significance.
Table 4. ANOVA for effectiveness of the post tests pain scores in the experimental group
Level of significance
Post test pain scores

Mean

SD
F value & p value

Pre- test on 3th day

3.90

0.303

Post test on 5th day

2.68

0.551

Post test on 7th day

1.94

0.424

***p<0.001, S significance.

H1 is accepted.
169.392
0.000*** S

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American Journal of Nursing Research

Table 4. Highlights that there was highly significant

difference found between the post tests pain level scores
of experimental group subjects, the calculated f value
shows 169.392 with p value 0.000 (p<0.001)***

Conflict of Interest

Table 5. Correlation between the wound healing & pain level scores
of subjects among experimental group
VARIABLE
Mean
SD
r value
Pain level
1.94
0.424
0.221
Wound healing
1.26
0.828

Acknowledgement

***p< 0.05, S - significant

Table 5. Shows that there is positive correlation

between the pain level and wound healing score r = 0.22,
indicates there is reduction of pain as the wound healing
occurs & vice versa.

there is no conflict of interest to disclose.

The author acknowledge the PG student and other

hospital staffs for co-operation during the period of study,
also acknowledges all the mothers for their co-operation
and consent for study.

References
[1]

3. Conclusion
The study result showed that infrared light application
was effective in enhancing wound healing & relieving
pain level among the caesarean mothers. All the subjects
in the experimental group had healed caesarean wound
and reduced pain level almost on 5th and 7thpost operative
day. This is also the cheapest procedure & convenient
measure. So this infrared light therapy can be
administered as an adjunct therapy by health personnel in
their day to day caring the mother in hospital setting.

4. Limitation
Time consuming
Man power and skilled person was needed to perform
the procedure.

[2]
[3]
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[9]
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5. Recommendation
Replication of the study may be done with large
samples in different setting to validate and generalize
the findings.
A comparative study can be done between elective
and emergency caesarean section mothers to find out
differences of degree of wound healing.
The findings can be used as evidence based for
providing infrared therapy among caesarean section
mothers.

[12]
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6. Ethical Consideration
Permission was obtained from the concern authority.
The subjects were selected based on the inclusion and
exclusion criteria for the study. Written consent was taken
from each subject before the intervention. Confidentiality
and anonymity were assured.

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