Purulent-Inflammatory Complications and Postoperative Hernias After Cesarean Section

Abstract

Any surgical intervention on the abdominal cavity, including caesarean section, is accompanied by several postoperative purulent-inflammatory complications, especially in patients with concomitant diseases. The most common purulent complications occur in the laparotomy area. They are suppuration of surgical wounds, necrotizing fasciitis, phlegmon and abdominal abscess. There are different opinions on the predictors of purulent complications. The most frequently mentioned are leukocyte count, C-reactive protein, procalcitonin, ferritin, and endocervical culture. Unfortunately, peritonitis and sepsis rates have not reduced recently. Still, these complications negatively affect treatment outcome. The paper discisses the effectiveness of drainage and lavage of the abdominal cavity during cesarean section. In this regard, preventive measures reducing the number and severity of purulent-inflammatory complications becomes relevant. First of all, this concerns intraoperative antibiotic prophylaxis, which should be carried out taking into account risk factors and the individual sensitivity of genital tract microorganisms to antimicrobial drugs. Obstetricians do not have a particular pattern to follow this technique. There is also ambiguous opinion on choosing an operative approach to reduce the number of postoperative ventral hernias. Both longitudinal and transverse laparotomies have certain advantages and disadvantages. Until now, the choice of postoperative ventral hernia repair, especially in the hypogastrium, is determined by many factors, which should be taken into account. These problems reveal the need for optimal measures aimed at reducing negative consequences of cesarean delivery. Articles from Cyberleninka, e-Library, disserCat, ResearchGate, JSTOR, PubMed, and Google Scholar were analyzed for the study.