HOW DOES POSTOPERATIVE ENDONASAL MUCOSA C ARE AFFECT THE NASAL BACTERIAL-FLORA - A STUDY OF 2 RINSING TECHNIQUES USING SALINE SOLUTION AFTER PARANASAL SINUS SURGERY

Background: Endonasal irrigation with saline solutions is a widely use d constituent of mucosal care after sinus surgery, This procedure coul d explain a repeatedly observed phenomenon: contamination of the endon asal mucosa by facultative skin pathogens from the palm during paranas al sinus irrigation, Method: For this reason the effect of nasal rinse s with saline solution on the endonasal bacterial flora was investigat ed (use of so-called nasal douche [Siemens & Co., Bad Ems] compared to rinsing by hand). In 36 patients (23 m., 13 f., 36 +/- 19.5 years of age) with chronic sinusitis, a total of 288 swabs was collected before , during, and after surgery. The collected specimens were transferred to a Port-A-Cul transport medium and processed within four hours. Resu lts: Two hundred sixty-six cultures of 325 bacterial strains were aero bic (82%), while 59 were anaerobic (18%). Staphylococcus aureus (33%) and representatives of the Enterobacteriaceae family (31%) were the mo st common enriched germs. The number of times that enterobacteriaceae could be isolated was significantly (p<0.05) lower (13%) when a nasal douche was used than when irrigation was done using the palm (38%). An irrigation technique-related effect was found on neither the spectrum of the pathagonic organisms nor the wound healing process. Conclusion : The frequent isolation of enterobacteria in nasal swabs of individua ls rinsing by hand consitutes the difference between irrigation by nas al douche and by hand in the postoperative care of the endonasal mucos a. These pathogens can sustain the paranasal sinus system.