Стан місцевого імунітету в породілей з інфекцією акушерської хірургічної рани в умовах війни

Abstract

Purpose - to study indicators of local immunity in the wound of women giving birth with an infection of an obstetric surgical wound in the conditions of war, which will give an opportunity to improve the therapy of wound infection at the present time. Materials and methods. Local immunity in the wound of 66 parturients with infected wounds during the war (the Group I) was studied and compared with indicators of local immunity in the wound of 76 parturients with infected wounds in peacetime (the Group II) six years to 2022. In addition, 15 healthy parturients - clinical remission (the Group III) were examined to determine the features of the course of the wound process. To study local immunity, the number of immunocompetent cells and phagocytic activity in biopsies from wounds, fixed immunoglobulins in smears-imprints were determined using the direct immunofluorescence method. Statistical data processing was carried out with the use of the application program package "Microsoft Excel 5.0" and the standard version "Statistica 8.0". The difference in indicators at Р<0.05 was considered statistically probable. Results and conclusions. In the examined women in labor with an infection of an obstetric surgical wound in the conditions of war under stressful conditions, there is a greater suppression of local immunity than in women in labor with this pathology in peacetime, which is expressed in the insufficient migration of immunocompetent cells to the focus of inflammation of the wound, especially B-lymphocytes, in the predominance of smears-imprints of plasma cells producing immunoglobulins of classes M and G, which lead to increased inflammation, inhibition of reparative processes in the wound, progression of the purulent-inflammatory process with the risk of septic complications during martial law, which leads to the correction of purulent wound therapy in obstetric practice during the war . The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the patients was obtained for the research.