title: [Effect of postoperative endonasal mucous membrane care on nasal bacterial flora: prospective study of 2 irrigation methods with NaCl solution after paranasal sinus surgery].
abstract: BACKGROUND
  Endonasal irrigation with saline solution is a widely used constituent of mucosal care after sinus surgery. This procedure could explain a repeatedly observed phenomenon: contamination of the endonasal mucosa by facultative skin pathogens from the palm during paranasal sinus irrigation.
  
  
  METHODS
  For this reason the effect of nasal rinses with saline solution on the endonasal bacterial flora was investigated (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.
  
  
  RESULTS
  Two hundred sixty-six cultures of 325 bacterial strains were aerobic (82%), while 59 were anaerobic (18%). Staphylococcus aureus (33%) and representatives of the Enterobacteriaceae family (31%) were the most 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.
  
  
  CONCLUSIONS
  The frequent isolation of enterobacteria in nasal swabs of individuals rinsing by hand constitutes the difference between irrigation by nasal douche and by hand in the postoperative care of the endonasal mucosa. These pathogens can sustain the paranasal sinus system.
authors.affiliation: Klinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Hals-chirurgie der Universität, Kiel.
authors.forename: V
authors.initials: V
authors.lastname: Johannssen
authors.forename: S
authors.initials: S
authors.lastname: Maune
authors.forename: H
authors.initials: H
authors.lastname: Erichsen
authors.forename: H
authors.initials: H
authors.lastname: Hedderich
authors.forename: J A
authors.initials: JA
authors.lastname: Werner
mesh_terms: D000328:Adult; D001431:Bacteriological Techniques; D015169:Colony Count, Microbial; D004755:Enterobacteriaceae / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000382:microbiology*; D011182:Postoperative Care / Q000295:instrumentation*; D011446:Prospective Studies; D012852:Sinusitis / Q000382:microbiology / Q000601:surgery*; D012965:Sodium Chloride; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013530:Surgical Wound Infection / Q000382:microbiology*; D007507:Therapeutic Irrigation / Q000295:instrumentation*
chemical_list: D012965:Sodium Chloride