Effect of chlorhexidine pretreatment on bacterial contamination at rhinoplasty field

Safety in Rhinoplasty: Avoidance and Management of Complications

Rhinoplasty is one of the most popular operations in the world. Despite its popularity, rhinoplasty complications are common and stem from a myriad of issues both subjective and objective in nature. Complications of rhinoplasty include scar, asymmetries, irregularities, imperfections, nasal airway obstruction, skin ischemia or necrosis, nasal collapse, nasal deformity, and overcorrection or undercorrection of a perceived nasal irregularity. A thorough understanding of these potential complications, along with strategies for avoidance and management, is critical for ensuring patient safety and optimizing surgical outcomes.

Klebsiella Aerogenes Infection on the Costochondral Graft of the Nose

ABSTRACT

Klebsiella aerogenes is a nosocomial and pathogenic bacterium that causes opportunistic infections including most types of infections. After rhinoplasty, the inserted costochondral graft could be a good material for bacterial growth due to less vascularization and difficult-to-reach antibiotics. The unusual bacterial infection should be considered for preventing poor aesthetic results including graft or implant loss when the surgical site infection is uncontrolled despite proper treatment and administration in aesthetic rhinoplasty surgery. The use of appropriate antibiotics for drug sensitivity may be necessary with bacterial culture tests. In this case, an unusual K. aerogenes infection on the costochondral graft of the nose and related treatment course was reported.

Validation of Three Different Sterilization Methods of Tilapia Skin Dressing: Impact on Microbiological Enumeration and Collagen Content

Tilapia fish skin has demonstrated promise as a stable and practical biological dressing to be used in wound and burn management. However, the appropriate sterilization technique of the Tilapia fish skin is crucial before its clinical application. The standard sterilization technique must eliminate harmful pathogens but maintain the structural and biochemical properties that could compromise the dressing function. This study investigated and compared the efficiency of three sterilizing agents; chlorhexidine gluconate 4% (CHG), povidone iodine 10% (PVP-I), and silver nanoparticles (25 μg/mL) (AgNPs), at three different times (5, 10, and 15 min) on Tilapia fish skin based on the microbial count, histological and collagen properties. Among the sterilization procedures, AgNPs showed rapid and complete antimicrobial activity, with a 100% reduction in microbial growth of the fish skin throughout the treated times. Furthermore, AgNPs did not impair the cellular structure or collagen fibers content of the fish skin. However, CHG and PVP-I caused alterations in the collagen content. This study demonstrated that the AgNPs treatment of Tilapia fish skin provided sterile skin while preserving the histological properties and structural integrity. These findings provide an efficient and quick sterilization method suitable for Tilapia fish skin that could be adopted as a biological dressing.

A reliable method to avoid contamination during cartilage graft preparation in septorhinoplasty

PURPOSE

The aim of the study is to determine the risk of contamination in the cartilage graft materials prepared on the swester table and those prepared in a sterile package, and to reveal a more reliable method by performing the microbiological examination of these materials.

METHODS

Cartilages removed from the nasal septum were divided into four pieces. The first part (Sample A) was directly placed into the medium. Sample B was prepared by being crushed in a sterile package. Sample C was prepared on the auxiliary swester table, and Sample D was prepared on the main swester table actively used by surgery team. All samples were transferred in a 1 ml brain heart(BH) liquid medium. From each BH medium, 100 µl culture was performed on blood agar, eosin-methylene blue-lactose-sucrose agar and chocolate agar.

RESULTS

Bacterial growth was detected in 2 of the samples A, in 4 of the samples B, in 24 of the samples C, and in 36 of the samples D. The number of patients with bacterial growth in the samples C and/or D despite no growth in the sample B was 35. When the samples A/B and C/D were compared in terms of bacterial growth, a significant difference was found in all matchings (p < 0.001 for all comparisons).  CONCLUSION: These findings showed that preparation of the cartilage grafts on the swester table was extremely risky for microbiological contamination. Arslan and his colleagues suggest that preparing a graft material in a sterile package is extremely simple, cheap, and it also reduces contamination risk significantly.