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
V. Johannssen et al., 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, Laryngo-, Rhino-, Otologie, 75(10), 1996, pp. 580-583
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.