V. V.Mekhedko, E.I.NazarovNational Medical Academy of Postgraduate Education named after P.L.Shupyk,
All-Ukrainian association of ozone therapists and manufacturers of the equipment.
Research-and-production enterprise Econika, Ukraine, www.ozonetherapy.org
As it is known, ptosis and prolapsus of the internal genitals make up to 28 % in structure of gynecologic diseases. The basic method of treatment of this disease is surgery. But microbic contamination of the operative wound occurs during surgical intervention, and the rate of postoperative inflammatory complications has no tendency to reduction and makes from 7 up to 25 %. The basic method of prevention of such complications is sanitation of postoperative wounds by antiseptics, but researches of efficacy of their application have shown their insufficient effect We have developed and introduced into practice a method of treatment of vaginal postoperative wounds with the ozonized olive oil which was prepared by barbotage of 100 ml of oil with ozone-oxygen mixture for 120 min with ozone concentration of 50 mg/l. We have applied the prepared ozonized oil in the form of applications to a vaginal postoperative wound daily, from the end of the operation up to discharge the patient from hospital.
The aim of the work is study of general immunity condition in patients with ptosis and prolapsus of the internal genitals who are preparing for surgery and changes in the postoperative period in treatment of wounds by traditional antiseptics and with application of ozone therapy.
To control efficacy of treatment womens condition of general immunity has been studied before operative treatment and on the 7th day of the postoperative period [1, 2].
The first, control group, comprised 30 women in whom sanitation of the vagina after surgery was made by antiseptics. The second, basic group was made by 30 patients in whom the ozonized olive oil was applied to the wound. The group of comparison was made by 20 women of the corresponding age without genital prolapsus.
While investigating the immune status of women with genital prolapsus before surgery we have found impairments of immune homeostasis which was determined by -lymphopenia (reduction of D3 + 1.4 time), decrease in the level of -suppressors (CD8 +) 1.3 time, B-lymphocytes (CD22 +) 1.2 time and natural killers (CD16 +) on an average 1.4 time in comparison with healthy women. Parameters of humoral immunity have also been lowered: serum IgG?? 1.7 times; IgA 1.6 times and IgM 1.7 times in comparison with healthy women that were evidence of formation of secondary immune insufficiency in women with genital prolapsus. Levels of circulating immune complexes, phagocytic index and phagocytic number were almost identical to those of healthy women.
On the 7th day after surgery a group of women where ozonized olive oil was applied to the vaginal wound were observed to have an increase in practically all parameters of cellular and humoral immunity: -lymphocytes (CD3 +) have increased by 14.7 %, helpers (CD4 +) by 12.0 %, suppressors (CD8 +) – by 25 %, B-lymphocytes (CD22 +) by 43.5 % and natural killers (CD16 +) by 41.7 %. Along with growth of amount of B-lymphocytes their functional activity increased too the amount of serum IgG has grown by 6.2 %, Ig by 21.1 %. Parameters of phagocytic index and phagocytic number reliably increased as well. Such immune response confirms the fact that stimulation of the immune response of the mucous membranes can result in stimulation of immune mechanisms of protection both in the mucous membranes and all over the organism. There were no positive dynamics observed in using the traditional methods of treatment of postoperative wounds by antiseptic preparations. It should be noted that healing of the postoperative wounds in women of the basic group occurred by a primary intension, in the control group complications were observed in 20 %. Hospital stay of patients of the basic group with application of the ozonized olive oil was by 2.7 days less after surgery than of the controls.
On the basis of analysis of the results obtained, we have received confirmation of the positive effect of the ozonized olive oil on general immunity due to significant restoration of parameters of cellular and humoral parts of immunity.
Thus, advantage of the method of treatment of vaginal postoperative wounds by applications of the ozonized olive oil in comparison with traditional methods shows that besides acceleration of wound healing process, there is an improvement of parameters of general immunity that allowed to recommend it for application in treatment of postoperative wounds in gynecologic departments.
1. McCluskie M.J., Davis H.L. Mucosal immunization With DNA vaccines//Microbes Infect., 1991 – 1, P. 685??- 698.
2. Mancini G., Carbonara A., Heremans I. Immunochemical quantitation of antitgens by singl radial immunodiffusion // Immunochemistry. 1965. V. 2. p. 235-254.

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