ASSESSMENT OF THE RISK OF SURGICAL INFECTION DURING SURGICAL INTERVENTIONS IN GYNECOLOGICAL PATIENTS
DOI:
https://doi.org/10.11603/24116-4944.2023.2.14285Keywords:
surgical site infection, microbial contamination, gynecology, infection controlAbstract
The aim of the study – to assess the risk of surgical infection during surgical interventions in gynecological patients.
Materials and Methods. The research was carried out on the basis of clinical divisions of the Department of Obstetrics and Gynecology of ONMedU in 2000–2022. 198 women aged 18–45 who underwent scheduled laparotomy and laparoscopic gynecological interventions via transabdominal access were examined. In addition, the level of microbial contamination of the skin of the lower part of the abdomen in the projection of the cut before and after the surgical intervention (on the 3rd, 7th and 14th day), as well as the fluid secreted by the drains and the drains themselves, was evaluated. Bacteriological studies were performed in a certified laboratory. The risk of surgery site infection (SSI) was assessed by the NHSN index. The dynamics of microbial contamination, the number of purulent-infectious complications were determined. Statistical processing was carried out by methods of dispersion and correlation analysis using Statistica 14.0 software (TIBCO, USA) and Excel (MS Inc., USA).
Results and Discussion. When assessing the level of microbial contamination at the preoperative stage, it was found that in 51.8 % of cases, the skin was contaminated with E. coli both in isolation and in combination with other microorganisms. In 1 % of the samples at the preoperative stage, Ps. aeruginosa In the postoperative period, a significant number of samples (58.1 %) were sterile, which can be explained by the use of local antiseptics. The remaining 83 (41.9 %) patients in the postoperative period had microbial growth, while the qualitative composition of the microflora changed due to a decrease in the quota of conditionally pathogenic flora.
Conclusions. 1. The presence of opportunistic flora on the skin at the site of the surgical incision is noted in 31.8 % of patients who are subject to planned surgical interventions. 2. There is a moderate positive correlation between the presence of opportunistic flora and BMI (rs=0.69). 3. In the postoperative period, even with the presence of opportunistic flora in the microbiocenosis, thanks to the application of standard operating procedures of infection control, no cases of purulent-septic complications were registered.
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