Prevention of Postoperative Purulent-Inflammatory Complications Using Photodynamic Therapy in Strangulated Hernias

Khasan Jafarov (PhD, Associate Professor, Department of General Surgery №3, Tashkent State Medical University, Tashkent)
Tohir Askarov (Dsc, Professor, Head of Department of General Surgery №3, Tashkent State Medical University, Tashkent)
Shuxrat Isakov (PhD, Assistant Professor, Department of Surgical Diseases, Tashkent State Medical University, Tashkent)
Erkin Zakhidov (Professor, Chief Researcher, Laboratory of Condensed Matter Optics, Institute of Ion-Plasma and Laser Technologies, Tashkent)
Mukhibjon Imomov (PhD, Senior Researcher, Laboratory of Condensed Matter Optics, Institute of Ion-Plasma and Laser Technologies, Tashkent)
Arzayim Sabirova (Assistant professor of the Department of Surgical diseases, Karakalpakstan Medical Institute, Nukus, Karakalpakstan)
Ansatbay Jambulov (Assistant professor of the Department of Surgical diseases, Karakalpakstan Medical Institute, Nukus, Karakalpakstan)

Academia Open
Vol. 11 No. 1 (2026): June

General Background: Postoperative infectious complications remain a major challenge in abdominal surgery, particularly in cases of strangulated abdominal hernias where microbial contamination of the surgical field frequently occurs. Specific Background: Photodynamic therapy using photosensitizers and light activation has been proposed as an antimicrobial approach, while methylene blue represents an accessible and low-cost photosensitizer that can be activated by LED irradiation. Knowledge Gap: Despite its potential advantages, the clinical and microbiological role of methylene-blue–mediated photodynamic therapy in preventing postoperative purulent-inflammatory complications in strangulated hernia surgery has not been sufficiently investigated. Aims: This study aimed to evaluate the microbiological characteristics of hernial sac infections and assess the preventive potential of intraoperative photodynamic therapy using methylene blue and LED irradiation. Results: A comparative clinical study of 225 patients showed that hernial sac infections were predominantly polymicrobial, with Escherichia coli (46%), Staphylococcus aureus (28%), and Staphylococcus epidermidis (6%) being the most common pathogens. Combined photodynamic treatment reduced microbial contamination from 10⁴ CFU/ml to 10² CFU/ml and lowered postoperative complications from 16.3% in the control group to 6.3% in the treated group, while also shortening hospital stay from 10.0 ± 0.67 days to 7.3 ± 0.77 days. Novelty: The study demonstrates the clinical and microbiological benefits of intraoperative photodynamic sanitation using methylene blue and LED light in strangulated hernia surgery. Implications: The findings support the use of accessible photodynamic techniques as a practical strategy for reducing postoperative purulent-inflammatory complications and improving surgical outcomes. Highlights:• Significant Decrease in Bacterial Contamination After Intraoperative Photodynamic Sanitation• Lower Frequency of Postoperative Purulent-Inflammatory Events in Treated Patients• Shorter Hospitalization Period Following Methylene-Blue–Based Photodynamic Treatment Keywords: Photodynamic Therapy, Strangulated Hernia, Methylene Blue, Surgical Site Infection, Postoperative Complications.