Microbiology of tracheal granulation tissue associated with silicone airway prostheses.
Granulation tissue formation and contraction is inevitable during the healing of open wounds. The presence of infection and a foreign body, such as a silicone airway prosthesis or other tracheotomy tube, magnifies this response. In airway reconstruction, wound contraction secondary to chronic inflammation is a liability. Cultures of granulation tissue were taken from 12 patients with silicone cannulas of T-Tubes. Polymicrobial colonization predominated, with variable combinations of gram-positive, gram-negative, and anaerobic organisms being present. On the basis of sensitivity data, amoxicillin-clavulanate potassium and ciprofloxacin hydrochloride were chosen as empirical antimicrobials. Anecdotally, impressive decreases in the quantity of granulation tissue were seen. We recommend a prospective trial to more accurately define the role of antibiotics in this setting.
Brown
M T
MT
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, USA.
Montgomery
W W
WW
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006097:Granulation Tissue / Q000382:microbiology* / Q000503:physiopathology*; D006801:Humans; D007769:Lactams; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants / Q000009:adverse effects*; D011552:Pseudomonas Infections / Q000188:drug therapy; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D012828:Silicones; D013203:Staphylococcal Infections / Q000188:drug therapy; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D014132:Trachea / Q000382:microbiology* / Q000503:physiopathology*
D000900:Anti-Bacterial Agents; D007769:Lactams; D012828:Silicones