DOI: https://doi.org/10.18370/2309-4117.2020.53.101-104

Prevention of postpartum infectious and inflammatory complications in women with injuries of the lower parts of genital tract

Л. Б. Маркін, Г. Б. Семенина, К. Л. Шатилович, Г. Я. Кунинець, О. В. Шахова

Abstract


Objective of the study: evaluation of the effectiveness of antimicrobial antiseptic drug Femiclean for prevention of wound infection in postpartum women with injuries of the lower parts of genital tract.

Materials and methods. A clinical and laboratory examination of 65 postpartum women was carried out. I observation group consisted of 33 women who underwent surgical treatment for perineal rupture of the II degree or episiotomy. Processing of external genitalia with disinfectant solutions (potassium permanganate, chlorhexidine) three times a day for the first 2–3 days, dry treatment of the perineum sutures with iodine solution for 5 days was performed to these patients. II observation group consisted of 32 women with a perineal rupture of II degree or episiotomy, who in addition to the above-indicated preventive and therapeutic measures were prescribed vaginal Femiclean tablets for 5 days.

Effectiveness of these measures was determined by presence of the postpartum complications (infiltration and suppuration in vaginal and perineum sutures), results of vaginal discharge microscopy (before and after treatment) and cytological smears from perineum sutures region (on the 5th day of the postpartum period).

Results. A more significant improvement of the vaginal bacteriological status following the treatment with Femiclean was in II group patients as compared with women in group I. The favorable course of tissue regeneration in all patients of group II, which was clinically confirmed by the absence of suppuration and dehiscence of perineal wound edges, proves the effectiveness of the dequalinium chloride drug for prevention of wound infection. One of the advantages of local drug administration is the lack of significant adverse effects on the lactobacilli pool, that is important for restoration of vaginal normocenosis in the puerperal period.

Conclusion. Topical application of the antiseptic drug Femiclean provides a 3-fold reduction in infectious and inflammatory complications incidence at trauma of the lower parts of genital tract.


Keywords


genital tract trauma; infectious and inflammatory complications; Femiclean

References


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GOST Style Citations


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3.            Bick, D., Kettle, C., Macdonald, S., et al. “Perineal Assessment and Repair Longitudinal Study (PEARLS): protocol for a matched pair cluster trial.” BMC Pregnancy Childbirth 10 (2010): 1–8. DOI: 10.1186/1471-2393-10-10

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8.            Wiseman, O., Rafferty, A.M., Stockley, J., et al. “Infection and wound breakdown in spontaneous second-degree perineal tears: An exploratory mixed methods study.” Birth 46 (2019): 80–9. DOI:10.1111/birt.12389

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14.          Liabsuetrakul, T., Choobun, T., Peeyananjarassri, K., et al. “Antibiotic prophylaxis for operative vaginal delivery.” Cochrane Database Syst Rev 8 (2017): CD004455. DOI: 10.1002/14651858.CD004455.pub4

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18.          Choudry, U., Harris, D. “Perineal wound complications, risk factors, and outcome after abdominoperineal resections.” Ann Plast Surg 71 (2013): 209–13. DOI: 10.1097/SAP.0b013e31823fac2b

19.          Lumbiganon, P., Thinkhamrop, J., Thinkhamrop, B., et al. “Vaginal chlorhexidine during labour for preventing maternal and neonatal infections.” Cochrane Database Syst Rev 9 (2014): CD 004070. DOI: 10.1002/14651858.CD004070.pub3

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21.          Kettle, C., Dowswell, T., Ismail, K.M. “Continuous and interrupted suturing techniques for repair of episiotomy or second-degree tears.” Cochrane Database Syst Rev 11 (2012): CD000947. DOI: 10.1002/14651858.CD000947.pub3

22.          Simon, E.G., Laffon, M. “Maternal care after vaginal delivery and management of complications in immediate post-partum. Guidelines for clinical practice.” J Gynecol Obstet Biol Reprod (Paris) 44 (2015): 1101–10. DOI: 10.1016/j.jgyn.2015.09.024

23.          Kamel, A., Khaled, M. “Episiotomy and obstetric perineal wound dehiscence: beyond soreness.” J Obstet Gynaecol 34 (2014): 215–7. DOI: 10.3109/01443615.2013.866080

24.          Jallad, K., Steele, S.E., Barber, M.D. “Breakdown of perineal laceration repair after vaginal delivery: a case-control study.” Female Pelvic Med Reconstr Surg 22 (2016): 276–9. DOI: 10.1097/SPV.0000000000000274

25.          Dudley, L., Kettle, C., Thomas, P.W., et al. “Perineal Resuturing Versus Expectant Management Following Vaginal Delivery Complicated by a Dehisced Wound (PREVIEW): A Pilot and Feasibility Randomised Controlled Trial.” BMJ Open 7 (2017): e012766. DOI: 10.1136/bmjopen-2016-012766

26.          Kumar, V., Abbas, A.K., Fausto, N., et al. Robbins and Cotran Pathologic basis of disease (8th ed.) Elsevier: USA (2014): 624 p.





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