Vaginal Cuff Infection After Hysterectomy in Ukraine

Salmanov, Aidyn G; Vitiuk, Alla D; Hrynchuk, Solomiia Ya; Bober, Anna S; Hrynchuk, Oksana B; Berestooy, Oleg A; Chernega, Tetiana V; Rud, Victor

doi:10.36740/wlek202102104

Cited by 6 publications

(1 citation statement)

References 22 publications

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“…Carbapenem resistance was identified in 7.3% of P. aeruginosa isolates. [ 14 ] Surgical instruments, when manipulated through the vaginal route during vaginal hysterectomy/vaginal cuff closure/vNOTES, increase the risk of ascending secondary infection of vaginal polymicrobial flora of aerobes and anaerobes to the open peritoneal cavity with pelvic hematoma. [ 15 16 ]…”

Section: Discussionmentioning

confidence: 99%

Vaginal Vault Closure Following Total Laparoscopic Hysterectomy: Laparoscopic versus Conventional Technique – A Comparative Study

Agarwal,

Sinha,

Singh

et al. 2023

Gynecology and Minimally Invasive Therapy

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Objectives: Vault closure is the final step to hysterectomy, protecting the abdominal cavity from the exterior environment. Thus, closure becomes crucial in preventing ascend of infection to the peritoneal cavity. Our study aims to compare vault closure between laparoscopic and vaginal routes, their operating time, and postoperative complications. Materials and Methods: The ambispective comparative study was done in a tertiary care teaching center from June 2016 to December 2022. Three hundred and forty-four patients were included in the study that underwent a total laparoscopic hysterectomy. Interventions – Patients who had laparoscopic vault closure were in Group 1 (N = 198) and those who had vaginal closure were in Group 2 (N = 146). The results were compared. It included age, body mass index of the patient, the indication of surgery, intraoperative blood loss, size of the uterus, time taken during vault closure, and postoperative complications. Results: The time taken by laparoscopic vault repair was significantly less than vaginal repair (19.7 ± 13.3 min vs. 30.1 ± 6.6 min, P < 0.001). There was postoperative vault infection (2.7%), vault hematoma (1.3%), and no vault prolapse seen in vaginal repair. The organisms isolated were mainly Pseudomonas aeruginosa, Escherichia coli, and Klebsiella. Conclusion: Laparoscopic vault closure has shown significantly improved results compared to vaginal route repair.

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Section: Discussionmentioning

confidence: 99%

Vaginal Vault Closure Following Total Laparoscopic Hysterectomy: Laparoscopic versus Conventional Technique – A Comparative Study

Agarwal,

Sinha,

Singh

et al. 2023

Gynecology and Minimally Invasive Therapy

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Postoperative Infections After Gynecological Surgeries in Ukraine

Salmanov,

Kostikov,

Lytvak

et al. 2023

Polski Merkuriusz Lekarski

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Aim: To determine the current prevalence of surgical site infections (SSIs) after gynecological surgeries and antimicrobial resistance of causing pathogens in Ukraine. Materials and Methods: Multicenter prospective observational cohort study was conducted from January 2020 to December 2022 in nine hospitals from eight regions of Ukraine. Definitions of HAIs were adapted from the Centers for Disease Control and Prevention’s National Healthcare Safety Network. Antibiotic susceptibility was done by the disc diffusion test as recommended by EUCAST. Results: A total 12.2% (420/3450) patients who undergoing gynecological surgeries were found to have SSIs. The difference in SSI rates between the three subgroups by route of surgery was not statistically significant, being 12.0% for the abdominal group,11.1% for the vaginal group, and 12.5% for the combined group. The most common causing pathogens of SSIs was Escherichia coli, Pseudomonas aeruginosa, Enterobacter spp., Streptococcus spp., and Klebsiella pneumoniae. Many Gram-negative pathogens isolated from SSI cases were found to be multidrug resistant. Conclusions: This study showed that SSIs remains the common complication after gynecological procedures in Ukraine. Best practices should be established and followed to reduce the risk of SSIs associated with gynecologic surgery. Optimizing the antibiotic prophylaxis and empirical antimicrobial therapy may reduce the burden of SSIs in gynecological surgeries, but prevention is the key element.

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Healthcare Associated Infection After Legal Induced Abortions in Ukraine: Results a Multicenter Study

et al. 2021

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The aim: To determine trend of legal induced surgical abortion and to assess the frequency of infection complications after termination of pregnancy in Ukraine. Materials and methods: We conducted a prospective multicentre cohort study was based on surveillance data of healthcare-associated infection (HAI) after legal induced surgical abortion in women’s from January 2017 to 2019 in Ukraine. Definitions of HAI after induced abortion were used from the CDC/ NHSN. Results: The number of surgical abortions in Ukraine increased by 32.8%. A total of 25.9% HAIs were identified after surgical abortion. Of these HAIs, 25.9 were Endometritis, 21.8% Bacterial Vaginitis, 14.3% Parametritis, 13.1% Cervicitis, 9.9% Adnexa utery, 7.8% Salpingitis, 6.3% Chorioamnionitis, and 0.9% other reproductive tract infections. E.coli were most commonly reported, accounting for 25.9% of all organisms, followed by Enterococcus spp. (16.2%), Staphylococcus aureus (15.5%), P. aeruginosa (10.9%), and Enterobacter spp. (10.1%). Antimicrobial resistance in the isolates associated with HAIs showed, among the gram-positive bacteria, that 19.1% and 3.6% of coagulase-negative staphylococci isolates were b-lactam (oxacillin) − and glycopeptide-resistant, respectively. Meticillin resistance was reported in 23.2% of S aureus isolates. Vancomycin resistance was reported in 3.7% of isolated enterococci. Among the gram-negative bacteria, third-generation cephalosporins resistance was found in 33.1% of Klebsiella spp and in 24.1% of E.coli isolates. Conclusions: The results of this study revealed high rates of HAIs after surgical abortion and most causing pathogens were associated with resistant to antibiotic strains. This knowledge is essential to develop targeted strategies to surveillance and reduce the incidence of post-abortion infections.

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Vaginal Cuff Infection After Hysterectomy in Ukraine

Cited by 6 publications

References 22 publications

Vaginal Vault Closure Following Total Laparoscopic Hysterectomy: Laparoscopic versus Conventional Technique – A Comparative Study

Vaginal Vault Closure Following Total Laparoscopic Hysterectomy: Laparoscopic versus Conventional Technique – A Comparative Study

Postoperative Infections After Gynecological Surgeries in Ukraine

Healthcare Associated Infection After Legal Induced Abortions in Ukraine: Results a Multicenter Study

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