Moellmann Henriette Louise, Kommer Katharina, Karnatz Nadia, Pfeffer Klaus, Henrich Birgit, Rana Majeed
Department of Cranio-and-Maxillo Facial Surgery, University Hospital Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany.
Institute of Medical Microbiology and Hospital Hygiene, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany.
J Clin Med. 2024 Jul 13;13(14):4103. doi: 10.3390/jcm13144103.
: In oral and maxillofacial surgery, the reconstruction of defects often involves the transfer of skin tissue into the oral cavity utilizing microvascular grafts. This study investigates postoperative changes in microbial colonization following intraoral microvascular transplantation, as well as potential influencing factors. : In 37 patients undergoing intraoral reconstructions, pre- and postoperative swabs were taken from the donor and recipient regions to quantify the seven selected marker bacteria using TaqMan PCRs. Patient-specific factors and clinical data were also recorded. : The infection-associated tended to decrease postoperatively, while the infectious pathogens , and the family of showed a postoperative increase without being directly associated with a clinical infection. showed a significant postoperative decrease on buccal mucosa and increase on the graft surface (oral dysbiosis) and was significantly reduced or displaced by other bacteria (e.g., , positive selection) when treated with ampicillin/sulbactam. The cutaneous microbiome of the graft adapts to the local intraoral environment. Postoperative shifts in oral bacterial colonization and an increase in infection-relevant bacteria were observed. These perioperative changes in colonization are also influenced by the administration of ampicillin/sulbactam. Consequently, single doses of antibiotics appear to be more beneficial compared to longer-term preventive use.
在口腔颌面外科中,缺损的重建通常涉及利用微血管移植物将皮肤组织转移至口腔内。本研究调查口腔内微血管移植术后微生物定植的变化以及潜在影响因素。在37例接受口腔内重建的患者中,术前和术后从供体和受体区域采集拭子,使用TaqMan聚合酶链反应(PCR)对七种选定的标记细菌进行定量。还记录了患者的个体因素和临床数据。与感染相关的[细菌名称未给出]术后往往减少,而感染性病原体[细菌名称未给出]、[细菌名称未给出]以及[细菌名称未给出]家族术后增加,但与临床感染无直接关联。[细菌名称未给出]在颊黏膜术后显著减少,在移植物表面增加(口腔生态失调),用氨苄西林/舒巴坦治疗时被其他细菌(如[细菌名称未给出],阳性选择)显著减少或取代。移植物的皮肤微生物群适应局部口腔内环境。观察到口腔细菌定植的术后变化以及与感染相关细菌的增加。这些定植的围手术期变化也受氨苄西林/舒巴坦给药的影响。因此,与长期预防性使用相比,单剂量抗生素似乎更有益。