title: Transseptal suturing technique in septoplasty: impact on bacteremia and nosocomial colonization.
abstract: Although effects of Merocel®nasal packs and silicone splints on nasal flora alterations and bacteremia formation after septoplasty were assessed before, the effect of transseptal suturing technique has not been studied yet. The objective of this study is to compare nasal flora alterations and bacteremia occurrence rates between Merocel packs, silicone splints, and transseptal suturing technique in septoplasty. Ninety patients were divided into three groups randomly: Merocel packing (Group M), silicone splint (Group S), and transseptal suturing without packing (Group T). Group M and S received prophylactic antibiotics and antibiotic pomade application to packs, whereas neither antibiotic prophylaxis nor topical pomade was applied to Group T. Preoperative, after pack removal and 1 month after pack removal nasal swab cultures and preoperative, immediately after surgery and 24 h after surgery blood cultures were taken from all patients. Group M increased Methicillin-sensitive Staphylococcus aureus (MSSA) colonization (p = 0.003) and decreased normal flora colonization (p = 0.038), whereas Group S and T did not affect MSSA or normal flora colonization (p > 0.05). Antibiotic prophylaxis did not affect MSSA colonization (p = 0.14), whereas decreased normal flora colonization (p = 0.029). Transseptal suturing did not prevent bacteremia formation. Postoperative increasing of MSSA colonization in nasal cavity for septoplasty patients can be prevented by using transseptal suturing technique or silicone splints instead of Merocel packing, rather than applying prophylactic antibiotic treatment. Using transseptal suturing does not prevent bacteremia formation during septal surgery. These findings should be kept in mind to prevent postoperative life-threatening infective complications of septoplasty especially in immunosuppressive patients and patients with cardiovascular diseases.
authors.affiliation: Mersin Üniversitesi Tıp Fakültesi Hastanesi, Kulak Burun Boğaz A.D Çiftlikköy Kampüsü, Çiftlikköy/Yenişehir, Mersin, Turkey. dronurismi@gmail.com.
authors.forename: Onur
authors.initials: O
authors.lastname: Ismi
authors.affiliation: Mersin Üniversitesi Tıp Fakültesi Hastanesi, Kulak Burun Boğaz A.D Çiftlikköy Kampüsü, Çiftlikköy/Yenişehir, Mersin, Turkey.
authors.forename: Cengiz
authors.initials: C
authors.lastname: Ozcan
authors.affiliation: Mersin Üniversitesi Tıp Fakültesi Hastanesi, Kulak Burun Boğaz A.D Çiftlikköy Kampüsü, Çiftlikköy/Yenişehir, Mersin, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Vayısoğlu
authors.affiliation: Department of Microbiology, Faculty of Medicine, University of Mersin, Mersin, Turkey.
authors.forename: Candan
authors.initials: C
authors.lastname: Öztürk
authors.affiliation: Department of Microbiology, Faculty of Medicine, University of Mersin, Mersin, Turkey.
authors.forename: Sebahat Aslan
authors.initials: SA
authors.lastname: Tek
authors.affiliation: Mersin Üniversitesi Tıp Fakültesi Hastanesi, Kulak Burun Boğaz A.D Çiftlikköy Kampüsü, Çiftlikköy/Yenişehir, Mersin, Turkey.
authors.forename: Kemal
authors.initials: K
authors.lastname: Görür
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D016470:Bacteremia / Q000517:prevention & control*; D001419:Bacteria / Q000302:isolation & purification; D001769:Blood / Q000382:microbiology; D003428:Cross Infection / Q000517:prevention & control*; D005260:Female; D005557:Formaldehyde; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000382:microbiology*; D009300:Nasal Septum / Q000382:microbiology / Q000601:surgery*; D011142:Polyvinyl Alcohol; D011183:Postoperative Complications / Q000517:prevention & control; D012225:Rhinoplasty / Q000379:methods; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013536:Suture Techniques
chemical_list: D000900:Anti-Bacterial Agents; D005557:Formaldehyde; C027490:polyvinyl alcohol formaldehyde foam; D011142:Polyvinyl Alcohol
keywords: Bacteremia; Colonization; Septoplasty; Transseptal suturing