Funahara M, Hayashida S, Sakamoto Y, Yanamoto S, Kosai K, Yanagihara K, Umeda M
Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Int J Oral Maxillofac Surg. 2015 Oct;44(10):1225-30. doi: 10.1016/j.ijom.2015.06.002. Epub 2015 Jun 26.
Parenteral antibiotic prophylaxis is the current standard of therapy in clean-contaminated oral cancer surgery. Nevertheless, the incidence of surgical site infection (SSI) in oral oncological surgery is relatively high, especially in major surgery with reconstruction and tracheotomy. The aims of this study were to investigate the perioperative condition related to microorganisms in the oral cavity and to examine the efficacy of the topical administration of tetracycline in reducing the number of bacteria in the oropharyngeal fluid during intubation. The number of oral bacteria was measured during intubation in patients undergoing major oral cancer surgery. The efficacy of the topical administration of tetracycline or povidone iodine gel in reducing the bacteria was then investigated. Bacteria in the oropharyngeal fluid grew from 10(6)CFU/ml to 10(8)CFU/ml during the 3h after intubation (CFU, colony-forming units). When tetracycline was applied to the dorsum of the tongue, oral bacteria decreased immediately to 10(5)CFU/ml, and the number of bacteria in the oropharyngeal fluid was maintained below 10(7)CFU/ml for 7h. The concentration of tetracycline in the oropharyngeal fluid was extremely high for several hours after topical administration. The topical administration of tetracycline could reduce oral bacteria in patients undergoing clean-contaminated oral cancer surgery. This method is expected to be effective in the prevention of SSI.
在清洁-污染的口腔癌手术中，肠外抗生素预防是当前的治疗标准。然而，口腔肿瘤手术中手术部位感染（SSI）的发生率相对较高，尤其是在进行重建和气管切开的大型手术中。本研究的目的是调查与口腔微生物相关的围手术期情况，并检验局部应用四环素在减少插管期间口咽分泌物中细菌数量方面的疗效。对接受大型口腔癌手术的患者在插管期间测量口腔细菌数量。然后研究局部应用四环素或聚维酮碘凝胶减少细菌的疗效。插管后3小时内，口咽分泌物中的细菌从10(6)CFU/ml增至10(8)CFU/ml（CFU，菌落形成单位）。当将四环素应用于舌背时，口腔细菌立即降至10(5)CFU/ml，并且口咽分泌物中的细菌数量在7小时内维持在10(7)CFU/ml以下。局部应用四环素后数小时内，口咽分泌物中四环素的浓度极高。局部应用四环素可减少接受清洁-污染口腔癌手术患者的口腔细菌。该方法有望有效预防手术部位感染。
