Optimization of postoperative period after surgical interventions on the cervix

Н. В. Косей, Т. Ф. Татарчук, С. И. Регеда, Н. Н. Евтушенко

Abstract


The article presents the results of research on optimizing postoperative period in patients who underwent surgical interventions on cervix.

134 patients were examined who underwent radiowave conization of the cervix for histologically confirmed CIN-2. By simple randomization, they were divided into two groups: Group I (66 women) received 2.0 ceftriaxone intraoperatively, and also Tamistol® vaginally for 1 suppository once a day for 3 days before surgery and for 12 days in postoperative period; patients of Group II (68 women) underwent only intraoperative prophylactic administration of 2.0 ceftriaxone.

The laboratory studies after the operative intervention, in particular, revealed a higher microbial load in Group II than in Group I after 21 days and 1.5 months after operation. In addition, when comparing subjective and objective clinical indices, it was noted that the course of the postoperative period in Group I was easier than in Group II.

It is proved that the use of complex prophylaxis that included local application of myramistin enhanced decontamination of vagina and cervix with bacterial and viral flora, benign сourse of postoperative period, fewer complications as well as faster and more complete epithelization of cervix after intervention. Considering the high incidence of sexually transmitted diseases in population, increase of the number of multimicrobal associations and the growing resistance of microbes to antibiotics the rationality of local antiseptic therapy in the complex of purulent-septic complications prevention in case of planned surgical interventions on cervix is concluded.

Local application of the drug Tamistol® showed its high effectiveness against such pathogens as Atopobium vag. and Mobiluncus mul., considered highly specific markers of bacterial vaginosis. Given the increasing resistance of these microorganisms to nitroimidazole drugs, the proven high efficacy of myramistin against these microorganisms allows us to draw conclusions about the preferred choice of the drug Tamistol® for the prevention of purulentseptic complications during surgical interventions.


Keywords


cervix; operation; antibacterial therapy; myramistin; Tamistol

References


Takac, I. “Human papillomavirus infection in patients with residual or recurrent cervical intraepithelial neoplasia.” Tumori 94.1 (2008): 83–6.

Nagai, Y., Maehama, T., Asato, T., Kanazawa, K. “Persistence of human papillomavirus infection after therapeutic conization for CIN 3: is it an alarm for disease recurrence?” Gynecol Oncol 79.2 (2000): 294–9.

Lamos, C., Mihaljevic, C., Aulmann, S., et al. “Detection of Human Papillomavirus Infection in Patients with Vaginal Intraepithelial Neoplasia.” Available from: [http:// journals.plos.org/plosone/article?id=10.1371/journal. pone.0167386], last accessed Aug, 27, 2017. DOI: 10.1371/journal.pone.0167386

Rodriguez-Cerdeira, C., Sanchez-Blanco, E., Alba, A. “Evaluation of Association between Vaginal Infections and High-Risk Human Papillomavirus Types in Female Sex Workers in Spain.” ISRN Obstet Gynecol (2012): 240190.

Huan Lu, Peng-Cheng Jiang, Xiao-Dan Zhang. “Characteristics of bacterial vaginosis infection in cervical lesions with high risk human papillomavirus infection.” International Jornal of Clinical and Experimental Medicine 8.11 (2015): 21080–8.

World Health Organization. Laboratory diagnosis of sexually transmitted infections, including human immunodeficiency virus. Ed. by Magnus Unemo (2013).

Kira, E.F., Muslimov, S.Z. Nonspecific vaginitis and its effect on the reproductive health of women. St. Petersburg (2001).

Centers for Deceases Control and Prevention. CDC Sexually Transmitted Diseases Treatment Guidelines (2015).

Senchuk, A.Y., Doskoch, I.O. “Efficiency of local use of combined drugs for the treatment of vulvovaginitis in gynecological practice.” Woman’s Health 1.57 (2011).

Hirsch, H.A. “Prophylactictis antibiotics in obstetrics and gynecology.” Am J Med 78 (1985).

Russian Society of Dermatovenereologists and Cosmetologists. Recommendations for the management of patients with sexually transmitted and urogenital infections (2012).

Popkova, S.M., Rakova, E.B., Khramova, E.E., et al. “Microecological combinations of vaginal and intestinal biotops in women with inflammatory diseases of the lower floor of the sexual tract.” Materials of the Congress “Pathology of the cervix”. Moscow (2013).

Lapach, S.N., Chubenko, A.V., Babich, P.N. Statistical methods in medical biology studies with use Excel. Kyiv. MORION (2000).


GOST Style Citations


1. Takac, I. “Human papillomavirus infection in patients with residual or recurrent cervical intraepithelial neoplasia.” Tumori 94.1 (2008): 83–6.

2. Nagai, Y., Maehama, T., Asato, T., Kanazawa, K. “Persistence of human papillomavirus infection after therapeutic conization for CIN 3: is it an alarm for disease recurrence?” Gynecol Oncol 79.2 (2000): 294–9.

3. Lamos, C., Mihaljevic, C., Aulmann, S., et al. “Detection of Human Papillomavirus Infection in Patients with Vaginal Intraepithelial Neoplasia.” Available from: [http:// journals.plos.org/plosone/article?id=10.1371/journal. pone.0167386], last accessed Aug, 27, 2017. DOI: 10.1371/journal.pone.0167386

4. Rodriguez-Cerdeira, C., Sanchez-Blanco, E., Alba, A. “Evaluation of Association between Vaginal Infections and High-Risk Human Papillomavirus Types in Female Sex Workers in Spain.” ISRN Obstet Gynecol (2012): 240190.

5. Huan Lu, Peng-Cheng Jiang, Xiao-Dan Zhang. “Characteristics of bacterial vaginosis infection in cervical lesions with high risk human papillomavirus infection.” International Jornal of Clinical and Experimental Medicine 8.11 (2015): 21080–8.

6. Всемирная организация здравоохранения. Руководство по лабораторной диагностике инфекций, передающихся половым путем (2013).

7. Кира, Е.Ф., Муслимов, С.З. Неспецифический вагинит и его влияние на репродуктивное здоровье женщины. – СПб., 2001.

8. Центры по контролю и профилактике заболеваемости (CDC) США. Руководство по лечению инфекций, передающихся половым путем (2015).

9. Сенчук, А.Я. Ефективність місцевого використання комбінованих препаратів для лікування вульвовагінітів у гінекологічній практиці» / А.Я. Сенчук, І.О. Доскоч // Здоровье женщины. – 2011. – №1 (57).

10. Hirsch, H.A. “Prophylactictis antibiotics in obstetrics and gynecology.” Am J Med 78 (1985).

11. Российское общество дерматовенерологов и косметологов. Рекомендации по ведению больных инфекциями, передаваемыми половым путем, и урогенитальными инфекциями (2012).

12. Попкова, С.М., Ракова, Е.Б., Храмова, Е.Е. и др. Микроэкологические сочетания вагинального и кишечного биотопов у женщин с воспалительными заболеваниями нижнего этажа полового тракта / Материалы конгресса «Патология шейки матки». – Москва, 2013 г.

13. Лапач, С.Н., Чубенко, А.В., Бабич, П.Н. Статистические методы в медико-биологических исследованиях с использованием Ехсеl. – К.: МОРИОН, 2000.





DOI: https://doi.org/10.18370/2309-4117.2017.36.49-56

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ISSN 2411-1295 (Online), ISSN 2309-4117 (Print)