Ukrainian Journal of Perinatology and Pediatrics. 2024. 2(98): 55-59; doi: 10.15574/PP.2024.98.55
Рrуlutska A. B., Martynova L. I., Kisilenko О. L., Govsіeіev D. О.
Bogomolets National Medical University, Kyiv, Ukraine

For citation: Рrуlutska AB, Martynova LI, Kisilenko ОL, Govsіeіev DО. (2024). The state of general immunity in women in labor with purulent wounds during hostilities. Ukrainian Journal of Perinatology and Pediatrics. 2(98): 55-59; doi: 10.15574/PP.2024.98.55.
Article received: Feb 27, 2024. Accepted for publication: Jun 15, 2024.

Aim – to develop a more effective method of treating purulent wounds in obstetric practice based on the study of microbiological factors in the development of wound infection in women giving birth in wartime conditions.
Materials and methods. Studied the qualitative and quantitative composition of the wound microflora in 66 women in labor with purulent wounds of the anterior abdominal wall after caesarean section and perineum after episiotomy and perineotomy under martial law and compared it with the indicators of bacteriological studies in 76 women in labor with purulent wounds of the anterior abdominal wall after caesarean section and perineum after episio-, perineotomy in peacetime. Statistical data processing was carried out using the package of application programs "Microsoft Excel 5.0" and the standard version "Statistica 8.0". The difference in indicators was considered statistically significant at P<0.05.
Results and conclusions. Based on the analysis of microbiological studies, it was determined that the causative agent of purulent wounds in obstetric practice during the war against the background of stress and greater suppression of both general and local immunity is opportunistically pathogenic flora, among which both gram-positive and gram-negative flora dominate, and in peacetime At that time, the most frequent causative agent of purulent wounds in women in labor was gram-positive flora, which was isolated both in monoculture and in association with gram-negative and anaerobic microorganisms.
The first place among gram-positive flora is occupied by St. Epidermidis and gram-negative – Acinetobacter. In 37.9%, inflammatory processes in the tissues of postoperative wounds arise under the influence of the symbiotic relationship of aerobic-anaerobic microorganisms, and in 57.6% – the association of aerobic microorganisms.
The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the parents was obtained from the mothers in labor for the research.
The authors declare no conflict of interest.
Keywords: microbiological studies, purulent wound, obstetrics, purulent-septic complications, qualitative and quantitative composition of flora.
REFERENCES

1. Belaya V, Zagorodnyaya A, Tsapenko T, Tymoshchuk K. (2021). Amniotic fluid glucose concentration as a marker of inflammation of the amniotic membranes during their premature rupture in preterm and full-term pregnancies. Reprod Health. Eastern Eur. 11(6): 708-716. https://doi.org/10.34883/PI.2021.11.6.003

2. Benskin LL. (2020). Commentary: First-Line Interactive Wound Dressing Update: A Comprehensive Review of the Evidence. Frontiers in Pharmacology. 11: 1272. https://doi.org/10.3389/fphar.2020.01272; PMid:33013362 PMCid:PMC7510500

3. Childs DR, Murthy AS. (2017). Overview of Wound Healing and Management. Surgical Clinics of North America. 97(1): 189-207. https://doi.org/10.1016/j.suc.2016.08.013; PMid:27894427

4. Fettke F, Schumacher A, Canellada A, Toledo N, Bekeredjian-Ding I, Bondt A et al. (2016, Dec 8). Maternal and Fetal Mechanisms of B Cell Regulation during Pregnancy: Human Chorionic Gonadotropin Stimulates B Cells to Produce IL-10 While Alpha-Fetoprotein Drives Them into Apoptosis. Front Immunol. 7: 495. https://doi.org/10.3389/fimmu.2016.00495; PMid:28008329 PMCid:PMC5144100

5. Ioffe Yu, Kindzer SL, Stetsenko OP, Halyha TM, Omelchenko AV. (2020). Zastosuvannia vakuumnoi terapii ran v likuvanni infektsiinykh uskladnen z boku pisliaoperatsiinykh ran. Shpytalna khirurhiia. Zhurnal imeni L.Ya. Kovalchuka. 3: 70-76. https://doi.org/10.11603/2414-4533.2020.3.11464

6. Khattak S, Wahid F, Liu LP, Jia SR, Chu LQ, Xie YY et al. (2019). Applications of cellulose and chitin/chitosan derivatives and composites as antibacterial materials: current state and perspectives. Applied Microbiology and Biotechnology. 103(5): 1989-2006. https://doi.org/10.1007/s00253-018-09602-0; PMid:30637497

7. Kuzyn MY, Kostiuchenok BM. (1990). Rani y ranevaia ynfektsyia. M.: Medytsyna: 591.

8. Martinengo L, Olsson M, Bajpai R, Soljak M, Upton Z, Schmidtchen A et al. (2019). Prevalence of chronic wounds in the general population: systematic review and meta-analysis of observational studies. Annals of Epidemiology. 29: 8-15. https://doi.org/10.1016/j.annepidem.2018.10.005; PMid:30497932

9. Mayet N, Choonara YE, Kumar P, Tomar LK, Tyagi C et al. (2014). A comprehensive review of advanced biopolymeric wound healing systems. Journal of Pharmaceutical Sciences. 103(8): 2211-2230. https://doi.org/10.1002/jps.24068; PMid:24985412

10. Mintser AP. (2018). Statisticheskie metodyi issledovaniya v klinicheskoy meditsine. Prakticheskaya meditsina. 3: 41-45.

11. Negut I, Grumezescu V, Grumezescu MA. (2018). Treatment Strategies for Infected Wounds. Molecules. 23(9): 2392. https://doi.org/10.3390/molecules23092392; PMid:30231567 PMCid:PMC6225154

12. Nguyen DB, Gupta N, Abou-Daoud A, Klekamp BG, Rhone C, Winston T et al. (2014). A polymicrobial outbreak of surgical site infections following cardiac surgery at a community hospital in Florida, 2011-2012. American Journal of Infection Control. 42(4): 432-435. https://doi.org/10.1016/j.ajic.2013.11.021; PMid:24679572 PMCid:PMC4620549

13. Nogueira F, Karumidze N, Kusradze I, Goderdzishvili M, Teixeira P, Gouveia IC. (2017). Immobilization of bacteriophage in wound-dressing nanostructure. Nanomedicine: Nanotechnology, Biology and Medicine. 13(8): 2475-2484. https://doi.org/10.1016/j.nano.2017.08.008; PMid:28842374

14. Norman G, Dumville J, Mohapatra D, Owens G, Crosbie E. (2016). Antibiotics and antiseptics for surgical wounds healing by secondary intention. Cochrane Database Syst. Rev. 3: CD011712. https://doi.org/10.1002/14651858.CD011712

15. Ousey K, Cutting KF, Rogers AA, Rippon MG. (2016). The importance of hydration in wound healing: reinvigorating the clinical perspective. Journal of Wound Care. 25(3): 122, 124-130. https://doi.org/10.12968/jowc.2016.25.3.122; PMid:26947692

16. Ozel A, Alici Davutoglu E, Yurtkal A, Madazli R. (2020). How do platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio change in women with preterm premature rupture of membranes, and threaten preterm labour? J Obstet Gynaecol. 40(2): 195-199. https://doi.org/10.1080/01443615.2019.1621807; PMid:31475592

17. Pei C, Kim Y, Baek K. (2019). Pathogenetic factors involved in recurrent pregnancy loss from multiple aspects.Obstet Gynecol Sci. 62(4): 212-223. https://doi.org/10.5468/ogs.2019.62.4.212; PMid:31338338 PMCid:PMC6629979

18. Prylutska AB. (2003). Porivnialna otsinka metodiv likuvannia hniinykh ran v akusherskii praktytsi. Dysert. … kand. med. n. Kyiv: 170.

19. Prylutska AB. (2021). Hentaksan, yak imunorehuliator pry hniinykh ranakh u porodilei. Likarska sprava. 2: 120-123.

20. Рrуlutska AB, Martynova LI, Avramenko SO, Yaroshchuk OB, Govsіeіev DО. (2023). Clinical-immunological approach to the treatment of obstetric surgical wound infection in women in labor. Ukrainian Journal Health of Woman. 6(169): 52-57. https://doi.org/10.15574/HW.2023.169.52

21. Рrуlutska AB, Martynova LI, Avramenko SO, Yaroshchuk OB, Pavliuchenko KS, Govsіeіev DО. (2023). The state of general immunity in women in labor with purulent wounds during hostilities. Ukrainian Journal of Perinatology and Pediatrics. 4(96): 44-49. https://doi.org/10.15574/PP.2023.96.44

22. Schumacher A, Costa SD, Zenclussen AC. (2014, May 8). Endocrine factors modulating immune responses in pregnancy. Front Immunol. 5: 196. PMID: 24847324; PMCID: PMC4021116. https://doi.org/10.3389/fimmu.2014.00196

23. Sel G. (2020). Perinatal Infections. In: Pract. Guid. to Oral Exams Obstet. Gynecol. Springer International Publishing. Cham: 45-50. https://doi.org/10.1007/978-3-030-29669-8_7

24. Shahshahan Z, Hashemi L. (2014). Maternal serum cytokines in predicting preterm labour and response to tocolytic therapy in preterm labour women. Adv Biomed Res. 3: 126. https://doi.org/10.4103/2277-9175.133243; PMid:24949297 PMCid:PMC4063106

25. Thinkhamrpop J, Hofmeyr J, Adetoro O, Lumbiganon P, Ota E. (2015). Antibiotic prophylaxis during the second and third trimester to reduce adverse pregnancy outcomes and morbidity. Cochrane Database Syst Rev. 26; 1: CD002250. https://doi.org/10.1002/14651858.CD002250.pub2

26. Zahorodnia O, Motsiuk Yu, Amerkhanova T. (2023). Polohova diialnist yak proiav systemnoi zapalnoi reaktsii. Reproduktyvne zdorov'ia zhinky. 4: 79-84. https://doi.org/10.30841/2708-8731.4.2023.285769