Prevention of infectious morbidity after elective abdominal hysterectomy

Abstract

Our aim was to investigate whether posthysterectomy infectious morbidity could be reduced by intravaginal therapy before operations. Women expected to undergo elective total abdominal hysterectomy were included. Vaginal flora was evaluated by preoperative Gram-stained vaginal smears up to Nugent's criteria. Study group were administered vaginal combination therapy including 500 mg metronidazole and 100 mg miconazole nitrate two times a day for 7 days. Control group were not given any preoperative vaginal therapy. Postoperative infectious morbidity was evaluated and compared. Ninety-five women in the study group and 97 women in the control group completed the study protocol. Women with abnormal flora had significantly more wound and vaginal cuff infections than the women with normal flora in the control group. Urinary infections were significantly higher in the study group (38.9 vs. 23.7 %) and vaginal cuff infections were significantly higher in the untreated control group (2.1 vs. 8.2 %). We concluded that postoperative vaginal cuff infections can be decreased by treating abnormal vaginal flora before elective abdominal hysterectomies.