Throat swabs taken on the operating table prior to cleft palate repair and their relevance to outcome: a prospective study.
OBJECTIVE
The main objective of this study was to determine whether bacteria cultured from oral swabs taken at the time of surgery predicted postoperative fistula formation.


METHODS
The study was a prospective longitudinal audit.


METHODS
The setting was a designated U.K. N.H.S. cleft center.


METHODS
Subjects consisted of the patients of a single cleft surgeon who were undergoing surgery for cleft palate repair or cleft fistula repair.


METHODS
Oral microbiological swabs were taken from patients while they were on the operating table just before surgery.


METHODS
The results from microbiological culture of the swabs were recorded, as was the presence or absence of a fistula at 6 months postoperatively. Additional collected information was related to the severity of the cleft, whether the operating microscope was used during surgery, and whether the patient had developed a postoperative upper respiratory tract infection.


RESULTS
Positive swab cultures were not significantly associated with fistula formation. Use of the operating microscope was not associated with an increase or decrease in the number of fistulas. A fistula developed in all patients who experienced a postoperative upper respiratory tract infection.


CONCLUSIONS
The practice of performing routine preoperative mouth swabs should be abandoned because the presence of bacteria in the mouth does not increase the risk of fistula formation.
Rennie
Andrew
A
New Cross Hospital, Wolverhampton, UK.
Treharne
Linda J
LJ
Richard
Bruce
B
D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D001419:Bacteria / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D002972:Cleft Palate / Q000145:classification / Q000601:surgery*; D015331:Cohort Studies; D019230:Dental Audit; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D008866:Microsurgery / Q000295:instrumentation; D009668:Nose Diseases / Q000209:etiology; D016155:Oral Fistula / Q000209:etiology; D010614:Pharynx / Q000382:microbiology*; D011183:Postoperative Complications; D011300:Preoperative Care; D011446:Prospective Studies; D016156:Respiratory Tract Fistula / Q000209:etiology; D012141:Respiratory Tract Infections / Q000209:etiology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013291:Streptococcus / Q000302:isolation & purification; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D019980:Amoxicillin-Potassium Clavulanate Combination