Effects of cesarean section duration on inflammation and postoperative parameters, a retrospective analysis

Yıl 2024, Cilt: 3 Sayı: 3, 102 - 106, 27.09.2024

Şükrü Bakırcı , Hilal Gözüyukarı , Sabri Kurtay , Ayşe Gizem Saraçoğlu , Banu Yüce Hacıpaşaoğlu

https://doi.org/10.5505/achmedj.2024.70299

Öz

Introductıon: Cesarean section it is the most frequently applied surgical application. Every surgical procedure creates an inflammation. Neutrophil to lymphocyte ratio (NLR), which can be easily obtained from complete blood count, is used as subclinical systemic inflammatory markers. In this study, our aim is to understand the effect of the duration of the cesarean section on subclinical inflammation by looking at the neutrophil/lymphocyte ratio and the effect of this period on blood loss and postoperative recovery
Methods: We included a total of 188 operations between the ages of 18-45 in our study and created 2 groups according to the duration of the cesarean section. When grouped as short (0-39 min) and long (≥40 min) according to the operation time, NOL change was higher in the group with longer operation duration, but no significant difference was found in both groups. Similarly, although the decrease in hemoglobin was higher in the group with a long operation time, no significant difference was found. No difference was observed between the two groups in terms of wound healing on the postoperative 10th day. When we look at our other parameters, we found a significant relationship between those whose cesarean section ended within 40 minutes and those who had their first cesarean section.
Results: As a result of our study, we could not detect a significant difference in the duration of the cesarean section operations performed in our clinic on the postoperative parameters.
Conclusion: Although supportive studies are needed, it shows that the surgical rules of cesarean section operate correctly under optimal conditions.

Anahtar Kelimeler

Cesarean, Inflammation, Surgical time

Kaynakça

• 1) Dölen İ, Özdeğirmenci Ö. Kadın Doğum Hekimliğinde Etik ve Yasal Sorunlar (Yeni düzenlemeler) Ed: Çiçek MN, Akyürek C, Çelik Ç, Haberal A. Güneş Kitabevi, 2006:155-164
• 2) Roe K. An inflammation classification system using cytokine parameters. Scand J Immunol. 2021 Feb;93(2):e12970. doi: 10.1111/sji.12970. Epub 2020 Sep 18. PMID: 32892387.
• 3) Doll DN, Barr TL, Simpkins JW. Cytokines: their roles in stroke and potential use as biomarkers and therapeutic targets. Aging Dis. 2014; 5(5): 294-306.
• 4) Kany S, Vollrath JT, Relja B. Cytokines in inflammatory disease. Int J Mol Sci. 2019; 2: 6008.
• 5) Francescone R, Hou V, Grivennikov SI. Cytokines, IBD and colitis-associated cancer. Inflamm Bowel Dis. 2015; 21(2): 409-418.
• 6) Lecureur V, Le Ferrec E, N’diaye M, et al. ERK-dependent induction of TNFα expression by the environmental contaminant benzo(a)pyrene in primary human macrophages. FEBS Lett. 2005; 579(9): 1904-1910.
• 7) Reikeras O, Borgen P, Reseland JE, Lyngstadaas SP. Changes in serum cytokines in response to musculoskeletal surgical trauma. BMC Res Notes. 2014; 7: 128.
• 8) Banerjee A, Khemka VK, Roy D, et al. Role of pro-inflammatory cytokines and vitamin D in probable Alzheimer’s disease with depression. Aging Dis. 2017; 8(3): 267-276.
• 9) Prasad S, Tyagi AK, Aggarwal BB. Detection of inflammatory biomarkers in saliva and urine: potential in diagnosis, prevention, and treatment for chronic diseases. Exp Biol Med. 2016; 241: 783-799.
• 10) Netea MG, Domínguez-Andrés J, Barreiro LB, et al. Defining trained immunity and its role in health and disease. Nat Rev Immunol 2020; 20:375.
• 11) Rehaume LM, Hancock RE. Neutrophil-derived defensins as modulators of innate immune function. Crit Rev Immunol 2008; 28:185.
• 12) Nauseef WM. How human neutrophils kill and degrade microbes: an integrated view. Immunol Rev 2007; 219:88.
• 13) Berliner N, Coates TD. Introduction to a review series on human neutrophils. Blood 2019; 133:2111.
• 14) Telo S, Kuluöztürk M, Deveci F, Kirkil G. The relationship between platelet-to-lymphocyte ratio and pulmonary embolism severity in acute pulmonary embolism. Int Angiol. 2019 Feb 1;38(1):4– 9.
• 15) Cheng H, Chen BP, Soleas IM, Ferko NC, Cameron CG, Hinoul P. Prolonged Operative Duration Increases Risk of Surgical Site Infections:A Systematic Review. Surg Infect (Larchmt). 2017 Aug/Sep;18(6):722-735. doi: 10.1089/sur.2017.089. PMID: 28832271; PMCID: PMC5685201.
• 16) Nguyen TJ, Costa MA, Vidar EN, et al.. Effect of immediate reconstruction on postmastectomy surgical site infection. Ann Surg 2012;256:326–333
• 17) Haridas M, Malangoni MA. Predictive factors for surgical site infection in general surgery. Surgery 2008;144:496–501
• 18) Li GQ, Guo FF, Ou Y, et al.. Epidemiology and outcomes of surgical site infections following orthopedic surgery. Am J Infect Control 2013;41:1268–1271
• 19) Bennett-Guerrero E, Welsby I, Dunn TJ, et al.. The use of a postoperative morbidity survey to evaluate patients with prolonged hospitalization after routine, moderate-risk, elective surgery. Anesth Analg 1999;89:514–519
• 20) Hoekstra LT, van Trigt JD, Reiniers MJ, et al.. Vascular occlusion or not during liver resection: The continuing story. Dig Surg 2012;29:35–42
• 21) Sessler DI, Akca O. Nonpharmacological prevention of surgical wound infections. Clin Infect Dis 2002;35:1397–1404
• 22) Enzler MJ, Berbari E, Osmon DR. Antimicrobial prophylaxis in adults. Mayo Clin Proc 2011;86:686–701
• 23) Willis-Owen CA, Konyves A, Martin DK. Factors affecting the incidence of infection in hip and knee replacement: An analysis of 5277 cases. J Bone Joint Surg Br 2010;92:1128–1133
• 24) Frecker MI, Powell KM, Haluck R. Design of a multifunctional compliant instrument for minimally invasive surgery. J Biomech Eng 2005;127:990–993
• 25) Daley BJ, Cecil W, Clarke PC, et al.. How slow is too slow? Correlation of operative time to complications: An analysis from the Tennessee Surgical Quality Collaborative. J Am Coll Surg 2015;220:550–558
• 26) Maoz G, Phillips M, Bosco J, et al.. The Otto Aufranc Award: Modifiable versus nonmodifiable risk factors for infection after hip arthroplasty. Clin Orthop Relat Res. 2015;473(2):453–9