title: Throat swabs taken on the operating table prior to cleft palate repair and their relevance to outcome: a prospective study.
abstract: 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.
authors: New Cross Hospital, Wolverhampton, UK.
authors: Andrew
authors: A
authors: Rennie
authors: Linda J
authors: LJ
authors: Treharne
authors: Bruce
authors: B
authors: Richard
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D019980:Amoxicillin-Potassium Clavulanate Combination