Prevention of infectious complications in minor gynecological surgeries

Abstract

S.A. Khlynova1, Yu.E. Dobrokhotova1, S.B. Kerchelaeva1, A.D. Fisenko1, V.I. Dimitrova2 1Pirogov Russian National Research Medical University, Moscow, Russian Federation 2F.I. Inozemtsev City Clinical Hospital, Moscow, Russian Federation Aim: to evaluate the efficacy of an antiseptic disinfectant containing benzyl-dimethyl-[3-(tetradecanoylamino)propyl] ammonium chloride as an active ingredient in the form of vaginal suppositories as a preoperative management for scheduled surgery in women with vaginal microbiocenosis disorder. Patients and Methods: a prospective open-label study of the prevention of postoperative complications in 58 women admitted to a gynecological short-stay unit was conducted. The initial examination included history taking, comprehensive clinical and laboratory examinations, bacterioscopy of cervical and vaginal discharge with Gram stain, and vaginal discharge pH measurement. Surgery (diagnostic dilation and curettage along with hysteroscopy for endometrial hyperplasia) was scheduled in all women. 8.0±1.0 days before surgery, preoperative treatment to prevent infectious complications was performed using benzyl-dimethyl-[3-(tetradecanoylamino)propyl] ammonium chloride monohydrate in the form of 15-mg vaginal suppositories (1 suppository), once daily for 7 days. 30 days after surgery, re-examination of vaginal microflora and microbiocenosis was performed in all women. Results: an increase in WBC count, mixed microflora, and Candida spores were detected at the first visit. Before preventive treatment, vaginal microbiocenosis was characterized by a decrease in the number of obligate microbes in the vaginal biotope. No infectious postoperative complications were reported, and the early and late postoperative period was uneventful. In 56 women (96.5%), normocenosis was revealed (19 women were previously diagnosed with bacterial vaginosis, 25 with candidiasis, and 12 with nonspecific vaginitis). Two women (3.5%) had intermediate-type vaginal microbiocenosis. In 54 women (93.1%), the preparation was well-tolerated, while 4 women (6.9%) complained of short-term burning. Conclusions: the preparation can be recommended as a preventive antiseptic agent before scheduled minor gynecological surgeries in women with vaginal microbiocenosis disorder. Keywords: minor gynecological surgeries, postoperative infectious inflammatory complications, prevention, vaginal microflora, hysteroscopy, antiseptic agent. For citation: Khlynova S.A., Dobrokhotova Yu.E., Kerchelaeva S.B., Fisenko A.D., Dimitrova V.I. Prevention of infectious complications in minor gynecological surgeries. Russian Journal of Woman and Child Health. 2023;6(3):270–275 (in Russ.). DOI: 10.32364/2618-8430-2023-6-3-9.