title: [Influence of nosocomial infections on resection of tracheal stenosis after tracheotomy].
abstract: BACKGROUND
  Complications located at the tracheostoma often occur in combination with nosocomial infections. We posed the question: how is the surgical result in tracheal resections influenced by bacterial contamination with multiresistant germs?
  
  
  METHODS
  Between 2005 and 2009 we performed a primary end-to-end-resection of the trachea after tracheotomy in 30 patients. The demographic basic data, the diagnostic data on tracheal stenosis after decanullation and type of tracheotomy were documented. Preoperatively all patients underwent a flexible bronchoscopy with bronchial lavage. All patients received an antibiotic inhalation therapy postoperatively.
  
  
  RESULTS
  16 patients presented a status post-permanent tracheotomy (PT), in 14 cases after percutaneous dilatative tracheotomy (PDT). In 64 % of all cases the preoperative bronchial lavage was positive for bacterial contamination. The major pathogen was with 23 % a multiresistant Pseudomonas aeruginosa (MR). In three cases long-term-complications occurred, all of which were bacterially contaminated.
  
  
  CONCLUSIONS
  After long-term intubation a bacterial contamination is very common and presents a negative predictor for the outcome of primary tracheal end-to-end resections. A prophylactic postoperative antibiotic therapy can improve the short- and long-term results.
authors.affiliation: Lungenklinik Merheim, Zentrum für Thoraxchirurgie, Pneumologie/Onkologie und Schlaf- und Beatmungsmedizin, Kliniken der Stadt Köln gGmbH. a_wolter@gmx.de
authors.forename: A
authors.initials: A
authors.lastname: Wolter
authors.forename: C
authors.initials: C
authors.lastname: Ludwig
authors.forename: F
authors.initials: F
authors.lastname: Beckers
authors.forename: E
authors.initials: E
authors.lastname: Stoelben
mesh_terms: D000328:Adult; D000368:Aged; D003428:Cross Infection / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000209:etiology* / Q000517:prevention & control*; D018570:Risk Assessment; D014135:Tracheal Stenosis / Q000150:complications* / Q000601:surgery*; D014140:Tracheotomy / Q000009:adverse effects*; D016896:Treatment Outcome