Arslan Fatih, Ocal Duygu, Yildiz Cemile Acikgoz, Dolapci Iştar
Department of Otolaryngology, Head and Neck Surgery, Beytepe Murat Erdi Eker State Hospital, Beytepe, 06640, Ankara, Turkey.
Department of Medical Microbiology, Ankara University School of Medicine, Ankara, Turkey.
Eur Arch Otorhinolaryngol. 2019 May;276(5):1385-1390. doi: 10.1007/s00405-019-05342-7. Epub 2019 Feb 15.
The aim of the study is to determine the risk of contamination in the cartilage graft materials prepared on the swester table and those prepared in a sterile package, and to reveal a more reliable method by performing the microbiological examination of these materials.
Cartilages removed from the nasal septum were divided into four pieces. The first part (Sample A) was directly placed into the medium. Sample B was prepared by being crushed in a sterile package. Sample C was prepared on the auxiliary swester table, and Sample D was prepared on the main swester table actively used by surgery team. All samples were transferred in a 1 ml brain heart(BH) liquid medium. From each BH medium, 100 µl culture was performed on blood agar, eosin-methylene blue-lactose-sucrose agar and chocolate agar.
Bacterial growth was detected in 2 of the samples A, in 4 of the samples B, in 24 of the samples C, and in 36 of the samples D. The number of patients with bacterial growth in the samples C and/or D despite no growth in the sample B was 35. When the samples A/B and C/D were compared in terms of bacterial growth, a significant difference was found in all matchings (p < 0.001 for all comparisons). CONCLUSION: These findings showed that preparation of the cartilage grafts on the swester table was extremely risky for microbiological contamination. Arslan and his colleagues suggest that preparing a graft material in a sterile package is extremely simple, cheap, and it also reduces contamination risk significantly.
本研究旨在确定在手术台上制备的软骨移植材料和在无菌包装中制备的软骨移植材料的污染风险，并通过对这些材料进行微生物学检查来揭示一种更可靠的方法。
从鼻中隔取下的软骨被分成四块。第一部分（样本A）直接放入培养基中。样本B是在无菌包装中碾碎制备的。样本C是在辅助手术台上制备的，样本D是在手术团队实际使用的主手术台上制备的。所有样本均转移至1毫升脑心（BH）液体培养基中。从每个BH培养基中，取100微升培养物接种于血琼脂、伊红美蓝乳糖蔗糖琼脂和巧克力琼脂上。
在样本A中有2个检测到细菌生长，样本B中有4个，样本C中有24个，样本D中有36个。尽管样本B中无细菌生长，但样本C和/或D中有细菌生长的患者有35例。当比较样本A/B和C/D在细菌生长方面的情况时，在所有配对中均发现有显著差异（所有比较的p值均<0.001）。结论：这些发现表明，在手术台上制备软骨移植材料存在极高的微生物污染风险。阿尔斯兰及其同事建议，在无菌包装中制备移植材料极其简单、便宜，而且还能显著降低污染风险。
