Цитологічні та морфологічні предиктори комплексного лікування інфекції акушерської хірургічної рани в породілей

Abstract

Purpose - to determination of the course and effectiveness of treatment of obstetric surgical wound infection in women in labor when using drugs with sorption-detoxification and immunomodulatory properties based on the study of the morphology of the wound process through the use of histological and cytological studies. Materials and methods. In the work, histological and cytological studies were used to monitor the course of the wound process in 115 parturients with purulent wounds of the anterior abdominal wall after caesarean section and perineum after episio- and perineotomy. Women are divided into groups depending on the method of treatment: the Group I - 42 parturients with purulent wounds, who were 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 - with subsequent statistical processing of the obtained results. Results. Based on the analysis of cytological and histological data, it was determined that the course of reparative processes in the wound during complex treatment with a sorbent and an immunomodulator is faster than that of monotherapy with a sorbent and conventional therapy - by 1.5-2 and 4-5 days, respectively. This was confirmed by a decrease in leukocytes, microorganisms, neutrophils and an increase in lymphocytes and connective tissue cells in the wound, affected the faster cleaning of the wound of dead and non-viable tissues, the rapid elimination of swelling and inflammation in the wound, and the acceleration of reparative processes. Conclusions. The complex use of an immunomodulator and a sorbent in the treatment of purulent wounds shows an advantage over sorbent monotherapy by accelerating the reparative processes in the wound by 1.5-2 days, and over traditional therapy by 4-5 days, which makes it possible to recommend them for use in practical medicine. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.