Hot Sitz Bath

and Perilite
Exposure
Prof. Marian Susan Z. Maglaqui
 Objectives of Hot Sitz Bath
• 1. Define the following terms: 7. Enumerate the
hot sitz bath radiation perilite disadvantages/advantages of:
exposure convection heat moist heat dry heat
application conduction  dry heat 8. Identify the indications and
episiotomy moist heat contraindications of:hot sitz bath
perilite exposure
perineorrhaphy
9. Give the principles involved in:
2. State the importance of: hot hot sitz bath perilite exposure
sitz bath perilite exposure 10. State the nursing
3. Discuss the process of heat responsibilities in:
transfer hot sitz bath perilite exposure
4. Cite the physiological 11. Explain the guidelines in:
responses to heat  hot sitz bath perilite exposure
5. List variables that influences 12. Demonstrate beginning skills in:
hot sitz bath perilite exposure
the effectiveness of heat
6. Discuss the therapeutic effect
 Hot Sitz bath & Perilite Exposure

• Hot Sitz bath 

– is a procedure whereby patient’s perineal area is submerged to water with
solutions depending on the needs of the client.
- a bath in which only the pelvic area is immersed in warm fluid.
• Perilite Exposure 
– application of dry heat to perineal area in order to provide comfort and increase blood
circulation and hasten wound healing by means of perineal lamp.
- 20-50 centimeters or 18-24 inches away from the body to be exposed.

• Heat application
– is a process of applying heat through radiation and convection 
 Dry heat
– requires a higher temperature and a longer period of heating
 Moist heat
- utilizes hot air that is heavily laden with water vapor
 Physiological responses to heat
• Vasodilation or increase in capillary surfaces 
- Heat causes vasodilation and increases blood flow to the affected area
bringing oxygen nutrients, antibodies and leukocytes.
• Increase in capillary permeability
- heat increases capillary permeability which allows extra cellular fluid and
substances such as plasma proteins to pass through the capillary walls
and may result in edema or an increase in pre-existing edema.
• Increase blood flow
• Increase cell metabolism
• Increase supply of nutrients
• Increase removal of wastes
• Relaxation of muscles
• Softening of exudates
• Increase peristalsis
• Increase body temperature
 Process of Heat Transfer
• Radiation 
- is the transfer of heat through electromagnetic radiation. For any body the
reflectivity depends on the wavelength distribution of incoming electromagnetic
radiation and therefore the temperature of the source of the radiation.

 Convection 
- is a combination of conduction and the transfer of thermal energy by fluid
circulation or movement of the hot particles in bulk to cooler areas in a material
medium.

 Conduction 
- is the transfer of thermal energy from a region of higher temperature to a region
of lower temperature through direct molecular communication within a medium
or between mediums in direct physical contact without a flow of the material
medium
• Variables that influences the effectiveness of heat
• Individual tolerance
– tolerance is influenced to some degree by age, condition of skin,
the 
condition of nervous and circulatory system. Young children,
elderly clients, diabetic clients and individuals with circulatory or
sensory alterations have low tolerance for heat.
- The very young and the very old generally have the lowest
tolerance. Persons 
- who have neurosensory impairments may have a high tolerance,
but the risk of injury is greater.
• General conditions of patient 
– shock or metabolic disorders such as diabetes increase the
hazard of tissue 
damage. Impaired perception because of individual’s level of 
consciousness, medications and mental impairment may make it
difficult 
• Whether the heat is moist or dry
– moist heat penetrates more deeply than dry heat because water is a good 
conductor of heat. Application of moist heat should be at a lower 
temperature than applications of dry heat.
• Size of skin area to be treated 
– the greater the body area to be treated, the lower the temperature should be.
• Environmental temperature 
– in warm or in humid environment, heat can’t be dissipated through 
evaporation to some degrees that it can dry or cool circumstances.
• Length of Exposure 
- People feel hot applications most while the temperature is changing. After a
period of time, tolerance increases.
• Location of area to be covered 
– individual tolerance to heat depends on the number of heat receptors in body 
parts. In general, the inner aspects of thighs and arms, the axillae, the chest 
and the abdomen are more sensitive to heat than the other parts of the body.

- The back of the hand and foot are not very temperature sensitive. In contrast the
inner aspect of the wrist and forearm, the neck, and the perineal area are
temperature sensitive.
• Therapeutic uses of heat

SEDATIVE EFFECT
- Heat is generally considered to produce a relaxation effect and increase the contractility of
muscles.

RELIEVES PAIN
- Heat relieves pain by promoting muscle relaxation, increasing circulation, and promoting
psychological 
relaxation and a feeling of comfort.

REDUCES CONTRACTURE AND INCREASES RANGE OF MOTION

- This effect is achieved by allowing greater distention of muscles and connective tissue.

REDUCES JOINT STIFFNESS

- Heat reduces joint stiffness by decreasing viscosity of synovial fluid and increasing tissue
distensibility. 

PROVIDES WARMTH AND COMFORT

• Dry Heat 
ADVANTAGES:
Less risks of burns to skin than moist application
Retains temperature longer since not influenced by evaporation 
Doesn’t cause maceration 

DISADVANTAGES:
increases body fluid loss through sweating 
Doesn’t penetrate deep into tissues 
Increase drying of skin
Moist Heat
ADVANTAGES:
Moist application reduces drying of skin and softens wound exudates
Warm moist doesn’t promote sweating and insensible fluid loss
Moist heat penetrates deeply into tissue layers
Moist compresses comfort well to area of body being treated

DISADVANTAGES:
Moist heat creates a greater risk for burns to skin since moisture conducts heat
Prolonged exposure can cause maceration of skin
Moist heat will cool rapidly because of moist evaporation 

-invisible heat rays readily seen in use of infrared; ultraviolet rays or electromagnetic waves
• Principles involved in Hot Sitz Bath

• HUMAN ANATOMY AND PHYSIOLOGY

- client who has episiotomy has painful hemorrhoids or vaginal inflammation may benefit from immersing pelvic area in
warm water.
- -sitz bath requires special attention to body posture ad limb position to avoid cramping and constriction of circulation
from pressure against edge of tub.

• MICROBIOLOGY
- application of heat to open wounds that may rupture may demand a sterile technique instruments should be sterile.

- application is for thermal effect and there’s no wound, materials should be kept cleaned to reduce transfer of bacteria.

• PSYCHOLOGY
• nurse should explain first the procedure to patient to gain cooperation
• nurse should know if patient is sensitive to warmness.

• CHEMISTRY
• heat generally is the speed of chemical reaction since metabolism is largely caused by chemical reactions, the
application of heat speeds metabolism either locally or generally
• the solvent action of water maybe increased by adding other substances like soap.
• Magnesium Sulfate is used for preterm labor or commonly used for treatment of preeclampsia to slow uterine
contractions.
•  PHYSICS

• heat is most valuable and most versatile physical for treatment.

• water has also great capacity, it undergoes change more slowly than other substances. It also gives off more heat.
• heat maybe transferred from 1 place to another by conduction, convection and radiation.
• application of heat & cold employs physical agents; heat, light & electricity.
• Nursing Responsibilities in Hot Sitz Bath
BEFORE:
• Check doctors order for desired solution and body part to be soaked at a desired temperature.
• Assess the condition of skin of the body to be immersed
• Explain procedure to the patient.
• Nurse must have adequate knowledge about the procedure.

DURING:
• Check the temperature of water in a sitz bath before the patient enters into the tub (40.5-43.5
degrees Celsius)
• Assist the patient into the tub and position her properly
• Wrap a blanket around patients shoulder
• Don’t leave the patient alone unless certain that its safe to do so

AFTER:
• Assist the patient in going out of the tub after the procedure is complete
• Assist patient to her bed, its best for her to be down, avoid draft until normal condition and
circulation returns
• Monitor patients general response to therapy and properly document significant data
• Do after care
• Principles involved in Perilite Exposure

• HUMAN ANATOMY AND PHYSIOLOGY 

• through blood vessels and nerves, skin and connections they make with nerves and blood vessels of body,
practically all parts of body maybe influenced by application of heat to skin.

• MICROBIOLOGY
• the application of heat to open wounds of lesions may rapture demands a sterile technique.

• BODY MECHANICS
• position of mother is dorsal recumbent with legs and knees flexed to allow proper exposure of area to be
treated

• PHYSICS
• application of heat employs physical agents: heat, water and light. Heat maybe transferred from one place
to another by radiation (perilite exposure) and convection (hot sitz) bath.

• PSYCHOLOGY
• nurse explains purpose of treatment in order to gain cooperation.

• SOCIOLOGY
• the patient needs to cooperate with nurse in order for treatment to be effective and to add patients early
recovery.
• Nursing Responsibilities in Perilite Exposure
BEFORE:
• Check the client’s condition before applying the procedure.
• Check all electrical equipment for defects or try to switch it on and off.
• Always handle equipment with dry hands
• Check physicians order for each area to be treated and duration of therapy
• Do perineal flushing

DURING:
• Position client comfortably with only area where heat is to be applied
• Position lamp at a safe distance from where it is to be applied
• Inspect skin and see to it that its clean and dry before applying heat 
• Place bed cover over lamp but not allowing bed sheet to touch the light bulb
• Check skin every 5 minutes interval throughout duration of procedure
• Monitor any untoward response
• Perilite exposure should be given 24 hours after delivery
• Place bed cover after pulling lamp and provide privacy
• Position lamp at 18-24 inches away from the body part to be exposed.

AFTER:
• Assist the client 
• Do after care 
• Monitor clients response 
• Do recording; record on patients chart 
- time when it started
- patients reaction
- condition of perineum
- inspect sutures and episiotomy after procedure
• Inspect condition of part being treated
• Hot Sitz Bath
INDICATIONS:
• Post partum mother with episiotomy wound 
• With rectal or vaginal surgery

CONTRAINDICATIONS:
• Patients with hemorrhage 
• Mother who had undergone CS delivery
• Multiparity with wound
• Before 24 hours of postpartum
 Indication

•  Episiotomy
– refers to an incision through the perineum that allows for less pressure
on the fetal head during delivery and prevents lacerations of the
perineum.

 Episiorraphy
-operation for repairing the episiotomy

 Perineorrhaphy 
– Operation for repairing laceration of perineum usually following delivery
• Guidelines for Hot Sitz Bath
• Check physicians order
• Nurse should explain the procedure
• Nurse should observe privacy
• Place towel at the patients back
• Adequate support during birth is essential 
• She should make sure the perineal region is immersed
• Check temperature of water for hotness
• Observe patient closely for 15-20 minutes
• If client feels like fainting, discontinue procedure
• Monitor vital signs before and after
• Guidelines for Perilite Exposure
• Explain procedure
• Instruct patient to do perineal flushing before perilite
exposure
• Check the equipment for any defects 
• Handle equipment with dry hands especially when your
about to plug it.
• Provide privacy during procedure 
• During exposure, keep lamp 20-50 cm away from
perineum.
• Heat lamp should be left in place for 15 minutes then
removed
• Perilite exposure process should be repeated 3-4 times a
day
• Washable parts of lamp should be wiped with antiseptic
solutions before its returned to storage area or used with
 IMPORTANCE OF PERILITE EXPOSURE

1. Relief of pain and muscular spasm

2. -provides comfort by relief pain
3. -it relaxes muscles and capillaries making pain tolerable
4. Increases blood circulation
5. Hastens wound healing following an episiotomy repair
6. -increases circulation of blood 
7. -increases supply of oxygen and nutrient which promotes wound
healing 
8. Reduces edema and soreness 
9. -it releases dry heat and thus help reduce edema and soreness
10. -alleviated by relax muscles and capillaries
Infrared Light