Optimization of rehabilitation management strategies for women with postoperative hematomas

Authors

DOI:

https://doi.org/10.18370/2309-4117.2026.83.47-54

Keywords:

streptokinase, streptodornase, hysterectomy, enzyme therapy, distrept enzymes H46A

Abstract

Objective of the study: to evaluate the clinical efficacy and safety of suppositories based on distrept enzymes H46A (streptokinase and streptodornase) in reducing the size of postoperative hematomas (POH), alleviating symptoms, and preventing chronicity in patients after hysterectomy.
Materials and methods. This prospective study included 69 women with POH following either transabdominal or transvaginal hysterectomy. Patients were randomized into two groups. The treatment group (group 1, n = 35) received a combined distrept enzymes H46A (streptokinase/streptodornase) preparation in the form of suppositories alongside standard antibacterial therapy for 12 days. The control group (group 2, n = 34) received only standard treatment. Clinical symptoms (pain intensity, hyperthermia), inflammation activity (C-reactive protein), and POH size based on ultrasound findings were evaluated at baseline (day 0), at the end of treatment (day 12), and after two weeks of follow-up (day 26).
Results. The treatment group demonstrated faster achievement of target body temperature levels, reduced inflammatory activity (as indicated by C-reactive protein levels of 8.9 ± 0.31 mg/L vs. 13.4 ± 0.41 mg/L in the control group, p < 0.001), and positive dynamics in pain syndrome across all POH localizations (p < 0.05). Ultrasound findings confirmed a more pronounced regression in POH size in the enzyme therapy group during the treatment and follow-up periods. Complete resorption of POH was observed in 46% of patients in group 1 immediately after the treatment course (day 12) and in 100% of cases at the end of the follow-up period. In group 2, target body temperature levels were achieved more slowly, and pain was more intense and prolonged. On days 12 and 26 of the study, POH persisted in 82% and 6% of patients in the control group, respectively (p < 0.05).
Conclusions. The use of local enzyme therapy with suppositories containing distrept enzymes H46A (streptokinase/streptodornase) in combination with standard antibacterial therapy demonstrated several advantages: reduced inflammatory activity, more pronounced regression of pain syndrome, increased rate of complete hematoma resorption, and a prolonged effect even after the treatment course was completed.

Author Biographies

N.F. Zakharenko, SSI «Center for Innovative Medical Technologies of the NAS of Ukraine», Kyiv

DSc, professor, leading researcher, Reproductive Health Department

N.V. Kosey, SSI «Center for Innovative Medical Technologies of the NAS of Ukraine», Kyiv

DSc, professor, head of the Reproductive Health Department

V.S. Solsky, SI «Ukrainian Center for Maternity and Childhood of the NAMS of Ukraine», Kyiv

PhD, senior researcher, Endocrine Gynecology Department

O.H. Parkhomenko, SI «Ukrainian Center for Maternity and Childhood of the NAMS of Ukraine», Kyiv

junior researcher, Endocrine Gynecology Department

S.V. Kulakov, SI «Ukrainian Center for Maternity and Childhood of the NAMS of Ukraine», Kyiv

leading engineer, Department of Endocrine Gynecology

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Published

2026-05-14

How to Cite

Zakharenko, N., Kosey, N., Solsky, V., Parkhomenko, O., & Kulakov, S. (2026). Optimization of rehabilitation management strategies for women with postoperative hematomas. REPRODUCTIVE ENDOCRINOLOGY, (83), 47–54. https://doi.org/10.18370/2309-4117.2026.83.47-54

Issue

No. 83 (2026)

Section

Interdisciplinary problems

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