grekovВестник хирургии имени И.И. ГрековаGrekov's Bulletin of Surgery0042-46252686-7370Federal State Budgetary Educational Institution of Higher Education «Academician I.P. Pavlov First St. Petersburg State Medical University» of the Ministry of Healthcare of the Russion Federation, FSBEI HE I.P.Pavlov SPbSMU MOH Russia10.24884/0042-4625-2022-181-5-70-77grekov-1831Research ArticleОБЗОРЫREVIEWSПрофилактика и лечение раневых инфекций после кесарева сеченияPrevention and treatment of wound infections after caesarean sectionhttps://orcid.org/0000-0003-2149-5957КрыловК. Ю.KrylovK. Yu.

Крылов Кирилл Юрьевич, кандидат медицинских наук, врач акушер-гинеколог, зав. отделением гинекологии

194044, Санкт-Петербург, ул. Чугунная, д. 46, лит. А.

Krylov Kirill Yu., Cand. of Sci. (Med.), Obstetrician-Gynecologist, Head of Gynecology Department

46, build. A, chugunnaia str., Saint Petersburg, 194044

drkrylov@mail.ruhttps://orcid.org/0000-0002-3548-0468РухлядаН. Н.RukhliadaN. N.

Рухляда Николай Николаевич, доктор медицинских наук, профессор, зав. кафедрой акушерства и гинекологии

Санкт-Петербург

Rukhliada Nikolaj N., Dr. of Sci. (Med.), Professor, Head of the Department of Obstetrics and Gynecology

Saint Petersburg

nickolasr@mail.ruБирюковаЕ. И.BiryukovaE. I.

Бирюкова Елена Игоревна, кандидат медицинских наук, врач акушер-гинеколог, зав. отделением гинекологии № 2

Санкт-Петербург

Biryukova Elena I., Cand. of Sci. (Med.), Obstetrician-Gynecologist, Head of the Department of Gynecology № 2

Saint Petersburg

79112252131@yandex.ruЦечоеваЛ. Ш.TsechoevaL. Sh.

Цечоева Лейла Шахмурзаевна, кандидат медицинских наук, врач акушер-гинеколог, зав. отделением гинекологии № 1

Санкт-Петербург

Tsechoeva Lejla Sh., Cand. of Sci. (Med.), Obstetrician-Gynecologist, Head of the Department of Gynecology № 1

Saint Petersburg

doctor-leila@mail.ruСанкт-Петербургское государственное бюджетное учреждение здравоохранения «Клиническая больница Святителя Луки»РоссияSt. Luke’s clinical HospitalRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Санкт-Петербургский государственный педиатрический медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияSaint-Petersburg State Pediatric Medical UniversityRussian FederationГосударственное бюджетное учреждение «Санкт-Петербургский научно-исследовательский институт скорой помощи имени И. И. Джанелидзе»РоссияSaint-Petersburg I. I. Dzhanelidze Research Institute of Emergency MedicineRussian Federation20220711202218157077Copyright © Крылов К.Ю., Рухляда Н.Н., Бирюкова Е.И., Цечоева Л.Ш., 20232023Крылов К.Ю., Рухляда Н.Н., Бирюкова Е.И., Цечоева Л.Ш.Krylov K.Y., Rukhliada N.N., Biryukova E.I., Tsechoeva L.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.vestnik-grekova.ru/jour/article/view/1831

Кесарево сечение (КС) – одна из наиболее распространенных акушерских операций в мире. Около 32 % всех родов заканчиваются путем кесарева сечения. Послеродовая инфекция в области хирургического вмешательства, раневая инфекция и эндометрит являются основными причинами длительного пребывания в родильных домах и являются источником дополнительных расходов для системы здравоохранения. В 2–16 % случаев развивается послеродовой эндометрит. Описано много факторов риска развития послеродовых инфекций. К ним относятся материнские факторы (такие как употребление табака, неадекватное дородовое наблюдение, ожирение, прием кортикостероидов; преждевременные роды, многополодная беременность и рубец на матке), внутриродовые и операционные факторы (такие как хориоамнионит, преждевременный разрыв плодных оболочек, длительный безводный период, затяжные роды, особенно длительный 2-ой период, большой разрез передней брюшной стенки; толщина подкожной клетчатки более 3 см, подкожная гематома, отсутствие антибиотикопрофилактики, стремительные роды, массивная кровопотеря в родах). Эффективные меры снижения частоты акушерских инфекционных осложнений включают профилактическое использование антибиотиков (предоперационная подготовка цефалоспоринами первого поколения и внутривенное введение азитромицина), обработку операционного поля хлоргексидином вместо йода, бритье непосредственно перед операцией, санация влагалища, удаление плаценты путем тракции пуповины, ушивание подкожной клетчатки, если глубина раны более 2 см и ушивание кожи швами вместо использования скоб. Создание обоснованного фактическими данными оптимального алгоритма помощи пациенткам после кесарева сечения может снизить частоту серьезных инфекционных осложнения.

Caesarean section (cS) is one of the most common obstetric operations in the world. About 32 % of all births end by caesarean section. Postpartum infection at the surgical site, wound infection and endometritis are the main causes of long stays in maternity hospitals and are a source of additional costs for the healthcare system. In 2–16 % of cases postpartum endometritis develops. Many risk factors for the development of postpartum infections have been described. These include maternal factors (such as tobacco use, inadequate prenatal care, obesity, corticosteroid use; prematurity, multiple gestation, and uterine scar), intrapartum and operative factors (such as chorioamnionitis; premature rupture of membranes; prolonged anhydrous period; prolonged labor , especially a long second period; large incision of the anterior abdominal wall; subcutaneous tissue thickness more than 3 cm; subcutaneous hematoma; lack of antibiotic prophylaxis; rapid labor; massive blood loss during childbirth). Effective measures to reduce the incidence of obstetric infectious complications include prophylactic use of antibiotics (preoperative preparation with first-generation cephalosporins and intravenous azithromycin), preoperative showering with chlorhexidine instead of iodine, shaving immediately before surgery, vaginal sanitation, removal of the placenta by traction of the umbilical cord, suturing of the subcutane-ous tissue, if the depth of the wound is larger than 2 cm and suturing the skin with sutures instead of using staples. Establishing an evidence-based optimal care algorithm for patients after caesarean section can reduce the incidence of serious infectious complications.

кесарево сечениеобработка операционного поляхирургические узлыраневые инфекциисанация влагалищаcaesarean sectionpreoperative showeringsurgical knotswound infectionsvaginal sanitationReferencesМатухин В. И., Малышава А. А., Резник В. А., Рухляда Н. Н., Тайц А. Н., Крылов К. Ю., Новицкая Н. Ю. Гипотеза формирования несостоятельного рубца на матке после операции кесарева сечения как фактора риска развития врастания плаценты // Проблемы репродукции. 2020. Т. 26, № 6. С. 114–121.Matukhin V. I., Malyshava A. A., Reznik V. A., Rukhlyada N. N., Taits A. N., Krylov K. Yu., Novitskaya N. Yu. Hypothesis of formation of an inconsistent uterine scar after cesarean section as a risk factor for placental ingrowth // Problems of Reproduction. 2020;26(6):114–121. (In Russ.).Liu S., Liston R. M., Joseph K. S. et al. Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term // CMAJ. 2007. Vol. 176, № 4. P. 455–60.Liu S., Liston R. M., Joseph K. S. et al. Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term // CMAJ. 2007;176(4):455–60.Mackeen A. D., Khalifeh A., Fleisher J. et al. Suture compared with staple skin closure after cesarean delivery: a randomized controlled trial // Obstet Gynecol. 2014. Vol. 123, № 6. P. 1169–75.Mackeen A. D., Khalifeh A., Fleisher J. et al. Suture compared with staple skin closure after cesarean delivery: a randomized controlled trial // Obstet Gynecol. 2014;123(6):1169–75.Wechter M. E., Pearlman M. D., Hartmann K. E. Reclosure of the disrupted laparotomy wound: a systematic review // Obstet Gynecol. 2005. Vol. 106. P. 376–83.Wechter M. E., Pearlman M. D., Hartmann K. E. Reclosure of the disrupted laparotomy wound: a systematic review // Obstet Gynecol. 2005;106:376–83.Blumenfeld Y. J., El-Sayed Y. Y., Lyell D. J. et al. Risk factors for prolonged postpartum length of stay following cesarean delivery // Am J Perinatol. 2015. Vol. 32, № 9. P. 825–32.Blumenfeld Y. J., El-Sayed Y. Y., Lyell D. J. et al. Risk factors for prolonged postpartum length of stay following cesarean delivery // Am J Perinatol. 2015; 32(9):825–32.Martens M. G., Kolrud B. L., Faro S. et al. Development of wound infection or separation after cesarean delivery. Prospective evaluation of 2,431 cases // J Reprod Med. 1995. Vol. 40. P. 171–5.Martens M. G., Kolrud B. L., Faro S. et al. Development of wound infection or separation after cesarean delivery. Prospective evaluation of 2,431 cases // J Reprod Med. 1995;40:171–5.Goepfert A. R., Guinn D. A., Andrews W. W. et al. Necrotizing fasciitis after cesarean delivery // Obstet Gynecol. 1997. Vol. 89, № 3. P. 409–12.Goepfert A. R., Guinn D. A., Andrews W. W. et al. Necrotizing fasciitis after cesarean delivery // Obstet Gynecol. 1997;89(3):409–12.Stevens D. L., Bisno A. L., Chambers H. F. et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America // Clin Infect Dis. 2014. Vol. 59, № 2. P. 147–59.Stevens D. L., Bisno A. L., Chambers H. F. et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America // Clin Infect Dis. 2014;59(2):147–59.Rosene K., Eschenbach D. A., Tompkins L. S. et al. Polymicrobial early postpartum endometritis with facultative and anaerobic bacteria, genital mycoplasmas, and Chlamydia trachomatis: treatment with piperacillin or cefoxitin // J Infect Dis. 1986. Vol. 153, № 6. P. 1028.Rosene K., Eschenbach D. A., Tompkins L. S. et al. Polymicrobial early postpartum endometritis with facultative and anaerobic bacteria, genital mycoplasmas, and Chlamydia trachomatis: treatment with piperacillin or cefoxitin // J Infect Dis. 1986;153(6):1028.Guzman M. A., Prien S. D., Blann D. W. Post-cesarean related infection and vaginal preparation with povidone-iodine revisited // Primary Care Update OB/GYNS. 2002. Vol. 9, № 6. P. 206–9.Guzman M. A., Prien S. D., Blann D. W. Post-cesarean related infection and vaginal preparation with povidone-iodine revisited // Primary Care Update OB/GYNS. 2002;9(6):206–9.Tran T. S., Jamulitrat S., Chongsuvivatwong V. et al. Risk factors for postcesarean surgical site infection // Obstet Gynecol. 2000. Vol. 95, № 3. P. 367–71.Tran T. S., Jamulitrat S., Chongsuvivatwong V. et al. Risk factors for postcesarean surgical site infection // Obstet Gynecol. 2000;95(3):367–71.Avila C., Bhangoo R., Figueroa R. et al. Association of smoking with wound complications after cesarean delivery // J Matern Fetal Neonatal Med. 2012. Vol. 25. P. 1250–3.Avila C., Bhangoo R., Figueroa R. et al. Association of smoking with wound complications after cesarean delivery // J Matern Fetal Neonatal Med. 2012;25:1250–3.Jama F. E. Risk factors for wound infection after lower segment cesarean section // Qatar Med J. 2012. Vol. 2. P. 26–31.Jama F. E. Risk factors for wound infection after lower segment cesarean section // Qatar Med J. 2012;2:26–31.De Vivo A., Mancuso A., Giacobbe A. et al. Wound length and corticosteroid administration as risk factors for surgical-site complications following cesarean section // Acta Obstet Gynecol Scand. 2010. Vol. 89, № 3. P. 355–9.De Vivo A., Mancuso A., Giacobbe A. et al. Wound length and corticosteroid administration as risk factors for surgical-site complications following cesarean section // Acta Obstet Gynecol Scand. 2010;89(3):355–9.Killian C. A., Graffunder E. M., Vinciguerra T. J. et al. Risk factors for surgical-site infections following cesarean section // Infect Control Hosp Epidemiol. 2001. Vol. 22. P. 613–7.Killian C. A., Graffunder E. M., Vinciguerra T. J. et al. Risk factors for surgical-site infections following cesarean section // Infect Control Hosp Epidemiol. 2001;22:613–7.Wloch C., Wilson J., Lamagni T. et al. Risk factors for surgical site infection following caesarean section in England: results from a multicentre cohort study // BJOG. 2012. Vol. 119, № 11. P. 1324–33.Wloch C., Wilson J., Lamagni T. et al. Risk factors for surgical site infection following caesarean section in England: results from a multicentre cohort study // BJOG. 2012;119(11):1324–33.Opøien H. K., Valbø A., Grinde-Andersen A. et al. Post-cesarean surgical site infections according to CDC standards: rates and risk factors. A prospective cohort study // Acta Obstet Gynecol Scand. 2007. Vol. 86, № 9. P. 1097–102.Opøien H. K., Valbø A., Grinde-Andersen A. et al. Post-cesarean surgical site infections according to CDC standards: rates and risk factors. A prospective cohort study // Acta Obstet Gynecol Scand. 2007;86(9):1097–102.Schneid-Kofman N., Sheiner E., Levy A. et al. Risk factors for wound infection following cesarean deliveries // Int J Gynaecol Obstet. 2005. Vol. 90. P. 10–5.Schneid-Kofman N., Sheiner E., Levy A. et al. Risk factors for wound infection following cesarean deliveries // Int J Gynaecol Obstet. 2005;90:10–5.Vermillion S. T., Lamoutte C., Soper D. E. et al. Wound infection after cesarean: effect of subcutaneous tissue thickness // Obstet Gynecol. 2000. Vol. 95, № 6 Pt 1. P. 923–6.Vermillion S. T., Lamoutte C., Soper D. E. et al. Wound infection after cesarean: effect of subcutaneous tissue thickness // Obstet Gynecol. 2000;95(6 Pt 1):923–6.Tuuli M. G., Liu L., Longman R. E. et al. Infectious morbidity is higher after second-stage compared with first-stage cesareans // Am J Obstet Gynecol. 2014. Vol. 211, № 4. P. 410.e1–6.Tuuli M. G., Liu L., Longman R. E. et al. Infectious morbidity is higher after second-stage compared with first-stage cesareans // Am J Obstet Gynecol. 2014;211(4):410.e1–6.Takoudes T. C., Weitzen S., Slocum J. et al. Risk of cesarean wound complications in diabetic gestations // Am J Obstet Gynecol. 2004. Vol. 191, № 3. P. 958–63.Takoudes T. C., Weitzen S., Slocum J. et al. Risk of cesarean wound complications in diabetic gestations // Am J Obstet Gynecol. 2004;191(3):958–63.Chaim W., Bashiri A., Bar-David J. et al. Prevalence and clinical significance of postpartum endometritis and wound infection // Infect Dis Obstet Gynecol. 2000. Vol. 8:77–82.Chaim W., Bashiri A., Bar-David J. et al. Prevalence and clinical significance of postpartum endometritis and wound infection // Infect Dis Obstet Gynecol. 2000;8:77–82.Olsen M. A., Butler A. M., Willers D. M. et al. Comparison of costs of surgical site infection and endometritis after cesarean delivery using claims and medical record data // Infect Control Hosp Epidemiol. 2010. Vol. 31. P. 872–5.Olsen M. A., Butler A. M., Willers D. M. et al. Comparison of costs of surgical site infection and endometritis after cesarean delivery using claims and medical record data // Infect Control Hosp Epidemiol. 2010;31:872–5.Smaill F. M., Grivell R. M. Antibiotic prophylaxis versus no prophylaxis for preventing infection after cesarean section // Cochrane Database of Systematic Reviews. 2014. Vol. 10. P. CD007482.Smaill F. M., Grivell R. M. Antibiotic prophylaxis versus no prophylaxis for preventing infection after cesarean section // Cochrane Database of Systematic Reviews. 2014;10:CD007482.Sullivan S. A., Smith T., Chang E. et al. Administration of cefazolin prior to skin incision is superior to cefazolin at cord clamping in preventing postcesarean infectious morbidity: a randomized, controlled trial // Am J Obstet Gynecol. 2007. Vol. 196. P. 455.e1–5.Sullivan S. A., Smith T., Chang E. et al. Administration of cefazolin prior to skin incision is superior to cefazolin at cord clamping in preventing postcesarean infectious morbidity: a randomized, controlled trial // Am J Obstet Gynecol. 2007;196:455.e1–5.Thigpen B. D., Hood W. A., Chauhan S. et al. Timing of prophylactic antibiotic administration in the uninfected laboring gravida: a randomized clinical trial // Am J Obstet Gynecol. 2005. Vol. 192. P. 1864–71.Thigpen B. D., Hood W. A., Chauhan S. et al. Timing of prophylactic antibiotic administration in the uninfected laboring gravida: a randomized clinical trial // Am J Obstet Gynecol. 2005;192:1864–71.Wax J. R., Hersey K., Philput C. et al. Single dose cefazolin prophylaxis for postcesarean infections: before vs after cord clamping // J Matern Fetal Med. 1997. Vol. 6. P. 61–5.Wax J. R., Hersey K., Philput C. et al. Single dose cefazolin prophylaxis for postcesarean infections: before vs after cord clamping // J Matern Fetal Med. 1997;6:61–5.Owens S. M., Brozanski B. S., Meyn L. A. et al. Antimicrobial prophylaxis for cesarean delivery before skin incision // Obstet Gynecol. 2009. Vol. 114, № 3. P. 573–9.Owens S. M., Brozanski B. S., Meyn L. A. et al. Antimicrobial prophylaxis for cesarean delivery before skin incision // Obstet Gynecol. 2009;114(3):573–9.American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 120: use of prophylactic antibiotics in labor and delivery // Obstet Gynecol. 2011. Vol. 117, № 6. P. 1472–83.American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 120: use of prophylactic antibiotics in labor and delivery // Obstet Gynecol. 2011;117(6):1472–83.Ahmadzia H. K., Patel E. M., Joshi D. et al. Obstetric surgical site infections: 2 grams compared with 3 grams of Cefazolin in morbidly obese women // Obstet Gynecol. 2015. Vol. 126, № 4. P. 708–15.Ahmadzia H. K., Patel E. M., Joshi D. et al. Obstetric surgical site infections: 2 grams compared with 3 grams of Cefazolin in morbidly obese women // Obstet Gynecol. 2015;126(4):708–15.Tita A. T., Hauth J. C., Grimes A. et al. Decreasing incidence of postcesarean endometritis with extended-spectrum antibiotic prophylaxis // Obstet Gynecol. 2008. Vol. 111, № 1. P. 51–6.Tita A. T., Hauth J. C., Grimes A. et al. Decreasing incidence of postcesarean endometritis with extended-spectrum antibiotic prophylaxis // Obstet Gynecol. 2008;111(1):51–6.Echebiri N. C., McDoom M. M., Aalto M. M. et al. Prophylactic use of negative pressure wound therapy after cesarean delivery // Obstet Gynecol. 2015. Vol. 125, № 2. P. 299–307.Echebiri N. C., McDoom M. M., Aalto M. M. et al. Prophylactic use of negative pressure wound therapy after cesarean delivery // Obstet Gynecol. 2015;125(2):299–307.Ngai I. M., Van Arsdale A., Govindappagari S. et al. Skin preparation for prevention of surgical site infection after cesarean delivery: a randomized controlled trial // Obstet Gynecol. 2015. Vol. 126, № 6. P. 1251–7.Ngai I. M., Van Arsdale A., Govindappagari S. et al. Skin preparation for prevention of surgical site infection after cesarean delivery: a randomized controlled trial // Obstet Gynecol. 2015;126(6):1251–7.Atkinson M. W., Owen J., Wren A. et al. The effect of manual removal of the placenta on post-cesarean endometritis // Obstet Gynecol. 1996. Vol. 87, № 1. P. 99–102.Atkinson M. W., Owen J., Wren A. et al. The effect of manual removal of the placenta on post-cesarean endometritis // Obstet Gynecol. 1996;87(1):99–102.Viney R., Isaacs C., Chelmow D. Intraabdominal irrigation at cesarean deli very: a ran domized controlled trial // Obstet Gynecol. 2012. Vol. 120. P. 708.Viney R., Isaacs C., Chelmow D. Intraabdominal irrigation at cesarean delivery: a randomized controlled trial // Obstet Gynecol. 2012;120:708.Yildirim G., Güngördük K., Asicioğlu O. et al. Does vaginal preparation with povidone-iodine prior to caesarean delivery reduce the risk of endometritis? A randomized controlled trial // J Matern Fetal Neonatal Med. 2012. Vol. 25, № 11. P. 2316–21.Yildirim G., Güngördük K., Asicioğlu O. et al. Does vaginal preparation with povidone-iodine prior to caesarean delivery reduce the risk of endometritis? A randomized controlled trial // J Matern Fetal Neonatal Med. 2012;25(11):2316–21.Tuuli M. G., Liu J., Stout M. J. et al. A randomized trial comparing skin antiseptic agents at cesarean delivery // N Engl J Med. 2016. Vol. 374, № 7. P. 647–55.Tuuli M. G., Liu J., Stout M. J. et al. A randomized trial comparing skin antiseptic agents at cesarean delivery // N Engl J Med. 2016;374(7):647–55.American College of Obstetricians and Gynecologists Women’s Health Care Physicians, Committee on Gynecologic Practice. Committee opinion no. 571: solutions for surgical preparation of the vagina // Obstet Gynecol. 2013. Vol. 122, № 3. P. 718–20.American College of Obstetricians and Gynecologists Women’s Health Care Physicians, Committee on Gynecologic Practice. Committee opinion no. 571: solutions for surgical preparation of the vagina // Obstet Gynecol. 2013;122(3):718–20.Walsh C. A., Walsh S. R. Extraabdominal vs intraabdominal uterine repair at cesarean delivery: a metaanalysis // Am J Obstet Gynecol. 2009. Vol. 200, № 6. P. 625.e1–8.Walsh C. A., Walsh S. R. Extraabdominal vs intraabdominal uterine repair at cesarean delivery: a metaanalysis // Am J Obstet Gynecol. 2009;200(6):625.e1–8.Tanner J., Norrie P., Melen K. Preoperative hair removal to reduce surgical site infection // Cochrane Database Syst Rev. 2011. № 11. P. CD004122.Tanner J., Norrie P., Melen K. Preoperative hair removal to reduce surgical site infection // Cochrane Database Syst Rev. 2011;(11):CD004122.Ahmed M. R., Aref N. K., Sayed Ahmed W. A. et al. Chlorhexidine vaginal wipes prior to elective cesarean section: does it reduce infectious morbidity? A randomized trial // J Matern Fetal Neonatal Med. 2016. Vol. 1. P. 1–4.Ahmed M. R., Aref N. K., Sayed Ahmed W. A. et al. Chlorhexidine vaginal wipes prior to elective cesarean section: does it reduce infectious morbidity? A randomized trial // J Matern Fetal Neonatal Med. 2016;1:1–4.Harrigill K. M., Miller H. S., Haynes D. E. The effect of intraabdominal irrigation at cesarean delivery on maternal morbidity: a randomized trial // Obstet Gynecol. 2003. Vol. 101, № 1. P. 80–5.Harrigill K. M., Miller H. S., Haynes D. E. The effect of intraabdominal irrigation at cesarean delivery on maternal morbidity: a randomized trial // Obstet Gynecol. 2003;101(1):80–5.Haas D. M., Morgan S., Contreras K. Vaginal preparation with antiseptic solution before cesarean section for preventing postoperative infections // Cochrane Database Syst Rev. 2014. № 9. P. CD007892.Haas D. M., Morgan S., Contreras K. Vaginal preparation with antiseptic solution before cesarean section for preventing postoperative infections // Cochrane Database Syst Rev. 2014;(9):CD007892.Johnson M. P., Kim S. J., Langstraat C. L. et al. Using bundled interventions to reduce surgical site infection after major gynecologic cancer surgery // Obstet Gynecol. 2016. Vol. 127, № 6. P. 1135–44.Johnson M. P., Kim S. J., Langstraat C. L. et al. Using bundled interventions to reduce surgical site infection after major gynecologic cancer surgery // Obstet Gynecol. 2016;127(6):1135–44.Hellums E. K., Lin M. G., Ramsey P. S. Prophylactic subcutaneous drainage for prevention of wound complications after cesarean delivery – a metaanalysis // Am J Obstet Gynecol. 2007. Vol. 197, № 3. P. 229–35.Hellums E. K., Lin M. G., Ramsey P. S. Prophylactic subcutaneous drainage for prevention of wound complications after cesarean delivery – a metaanalysis // Am J Obstet Gynecol. 2007;197(3):229–35.Postoperative complications // Diagnosis & Treatment: surgery, 13 th edition / eds. by Doherty G. M. New York : McGraw-Hill, 2010.Postoperative complications // Diagnosis & Treatment: surgery, 13 th edition / eds. by Doherty G. M. New York, McGraw-Hill, 2010.Ubbink D. T., Westerbos S. J., Evans D. et al. Topical negative pressure for treating chronic wounds // Cochrane Database Syst Rev. 2008. № 3. P. CD001898.Ubbink D. T., Westerbos S. J., Evans D. et al. Topical negative pressure for treating chronic wounds // Cochrane Database Syst Rev. 2008;(3): CD001898.Swift S. H., Zimmerman M. B., Hardy-Fairbanks A. J. Effect of singleuse negative pressure wound therapy on Postcesarean infections and wound complications for high-risk patients // J Reprod Med. 2015. Vol. 60, № 5–6. P. 211–8.Swift S. H., Zimmerman M. B., Hardy-Fairbanks A. J. Effect of single-use negative pressure wound therapy on Postcesarean infections and wound complications for high-risk patients // J Reprod Med. 2015;60(5–6):211–8.Chelmow D., Rodriguez E. J., Sabatini M. M. Suture closure of subcutaneous fat and wound disruption after cesarean delivery: a metaanalysis // Obstet Gynecol. 2004. Vol. 103, № 5 (Pt 1). P. 974–80.Chelmow D., Rodriguez E. J., Sabatini M. M. Suture closure of subcutaneous fat and wound disruption after cesarean delivery: a meta-analysis // Obstet Gynecol. 2004;103(5 Pt 1):974–80.Stevens D. L., Bisno A. L., Chambers H. F. et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America // Clin Infect Dis. 2014. Vol. 59, № 2. P. 147–59.Stevens D. L., Bisno A. L., Chambers H. F. et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America // Clin Infect Dis. 2014;59(2):147–59.Darenberg J., Ihendyane N., Sjölin J. et al. Intravenous immunoglobulin G therapy in streptococcal toxic shock syndrome: a European randomized, double-blind, placebo-controlled trial // Clin Infect Dis. 2003. Vol. 37, № 3. P. 333–40.Darenberg J., Ihendyane N., Sjölin J. et al. Intravenous immunoglobulin G therapy in streptococcal toxic shock syndrome: a European randomized, double-blind, placebo-controlled trial // Clin Infect Dis. 2003;37(3):333–40.

The authors declare that there are no conflicts of interest present.