Мікробіологічні предиктори комплексного лікування інфекції акушерської хірургічної рани в породілей

Abstract

Aim - based on the study of microbiological factors of the wound process, determine the effectiveness of treatment of obstetric surgical wound infection in women in labor when using drugs with sorption-detoxification and immunomodulatory properties. Materials and methods. Іn the work, microbiological studies were used to control the course of the wound process in 115 parturients with purulent wounds of the anterior abdominal wall after caesarean section and perineum after episiotomy, perineotomy, which, depending on the treatment method, were divided into groups: the Group I - 42 parturients with purulent wounds, which treated with organosilicon sorbent gentaxan; the Group II - 45 women in labor with purulent wounds, who were treated with organosilicon sorbent Gentaxan and immunomodulator Laferon; the Group III - 28 women in labor with purulent wounds, who were treated with traditional methods. The obtained results were processed by methods of statistical analysis. Results. Based on the analysis of microbiological studies, it was determined that the causative agent of purulent wounds in obstetric practice is opportunistic flora, among which S. epidermis. In 28.7%, inflammatory processes in the tissues of postoperative wounds arise under the influence of the symbiotic relationship of aerobic and anaerobic microorganisms. Complex treatment with gentaxan and laferon had an advantage over monotherapy with gentaxan and traditional methods, due to a more pronounced suppression of the pathogenic microflora of the wound and an increase in the number of microbes in its tissues in a shorter period of time, which accelerates the elimination of swelling and inflammation in the wound, the manifestation of symptoms that indicate complete healing biological cleaning of the wound, which, in turn, prevents contamination by hospital infection of the wounds of women in labor and further spread of the inflammatory process. Conclusions. The factor of wound infection is opportunistically pathogenic flora, which in 64.0% is isolated in aerobic and aerobic-anaerobic associations. Complex therapy of purulent wounds with drugs with sorption-detoxification and immunomodulatory properties increases the effectiveness of the treatment, due to the suppression of the pathogenic microflora of the wound and the increase of the number of microbes in its tissues in a shorter period of time, which prevents contamination by hospital infection of the wounds of women in labor and the further spread of the inflammatory process. The research was carried out in accordance with the principles of the Declaration of Helsinki. Research protocol approved by the Local Ethics Committee of the institution mentioned in the work. For conducting research informed consent of the parents was obtained from the women in labor. The authors declare no conflict of interest.