Optimization of perioperative management during reconstructive and aesthetic operations in gynecology

The objective: to evaluate the effectiveness of hyaluronic acid-containing vaginal suppositories (Hyal Meno, Hyal Eroz) in pre- and postoperative period in patients who undergoing vaginal surgical interventions.Materials and methods. The study included 37 patients with vaginal surgical procedures. The women were divided into three groups according to the local treatment protocol lasting up to 30 days: Group 1 received Hyal Eroz after reconstructive operations with antiseptic irrigations; Group 2 – Hyal Meno preoperatively as well as alternated Hyal Meno with Hyal Eroz postoperatively; Group 3 (the control group) were receiving a routine antiseptic care only. The duration of epithelialization, the frequency of complications, subjective symptoms were assessed using the Vulvovaginal Symptoms Questionnaire scale and the Vaginal Health Index visual analogue scale, pH and vaginal microbiocenosis according to the Hay–Ison standard.Results. The use of hyaluronic acid-based suppositories significantly reduced the epithelialization time of the mucous membrane, reduced postoperative inflammation, and normalized microbiocenosis restoration. Epigallocatechin-3-gallate, which is part of the suppositories, demonstrates pronounced antiproliferative and antifibrotic properties, inhibiting transforming growth factor-beta and vascular endothelial growth factor signaling pathways. This contributes to the reduction of pathological cell proliferation, inhibition of neoangiogenesis, and prevention of hypertrophic scarring and tissue deformities. The best results were observed in Group 2 (a combined treatment scheme), with mean epithelialization time of 10 days.Conclusions. Combined pre- and postoperative use of Hyal Meno and Hyal Eroz is a pathogenetically justified and clinically effective approach that improves mucosal regeneration and reduces complications after vaginal surgery. The combined scheme of their use provides the highest clinical effectiveness and improves the restoration of the mucous membrane.