Estudo da repercussão da cirurgia por via transvaginal sobre a microbiota vaginal

• Ano de defesa: 2017
• Autor(a) principal: Gavioli, Karine Rhein [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• dARK ID: ark:/48912/001300001zcnn
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Antisepsis; Microbiome; Infection control; Bacterial infection; Antissepsia; Microbiota; Controle de infecções; Infecções bacterianas
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5439359; http://repositorio.unifesp.br/handle/11600/50358

The search for minimally invasive surgeries is increasingly frequent, aiming at the use of smaller incisions, in order to minimize inflammation resulting from surgical trauma. The transvaginal route showed benefits related to direct access to pelvic organs, fast recovery, lower complication rate and low cost. However, reports in the literature question a possible increased risk of surgical site infection compared to the abdominal and laparoscopic access, due to the presence of the microbiota of the vaginal mucosa. Objective: To evaluate the effect of vaginal surgery and its relation with surgical site infection, antisepsis and vaginal microbiota. Methods: Patients (n = 34) were submitted to tubal ligation through the vaginal access and evaluated for: antisepsis effect by microbial cultures and by real time PCR; postoperative infection; and balance of the vaginal microbiota by real time PCR and sequencing at the 7 and 30 postoperative days. Results: Antisepsis promoted a significant reduction of the microorganism of the vaginal mucosa and no patient in the study had surgical site infection. The procedures involved in transvaginal route altered the microbiota and did not allow the recovery of the proportion and diversity of the bacterial genera in the studied periods. Conclusions: 1) The transvaginal access was not a risk factor for surgical site infection. 2) The microbial reduction of the vaginal cavity by antisepsis was significant and this fact may have contributed to the prevention of surgical site infection 3) The recovery of the vaginal microbiota occurred quantitatively but not for the diversity and proportion of bacterial genera in the period of 30 postoperative days.