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Tracheal granulation tissue. A study of bacteriology
B H Matt1, C M Myer, C J Harrison
1Department of Pediatric Otolaryngology and Maxillofacial Surgery, Children's Hospital Medical Center, Cincinnati, OH 45229-2899.
Archives of Otolaryngology--Head & Neck Surgery
|May 1, 1991
Summary
Granulation tissue in laryngotracheal reconstructions is often polymicrobial, with common bacteria like Pseudomonas aeruginosa. Tissue and bacterial load decrease after Teflon stent removal, suggesting further study on antimicrobial therapy is needed.
Area of Science:
- Otolaryngology
- Microbiology
- Surgical Research
Background:
- Granulation tissue formation is a common complication following laryngotracheal reconstruction (LTR).
- The bacteriology of this granulation tissue, particularly in relation to Teflon stent use, requires further elucidation.
- Understanding the microbial environment is crucial for optimizing LTR outcomes.
Purpose of the Study:
- To prospectively evaluate the bacteriology of granulation tissue in patients undergoing LTR with Teflon stents.
- To compare microbial findings at the time of stent removal versus a later laryngoscopy.
- To assess the relationship between granulation tissue burden, stenting duration, and microbial load.
Main Methods:
- Prospective examination of 19 patients (21 LTRs) over a 6-month period.
- Collection of granulation tissue samples at Teflon stent removal and subsequent laryngoscopy.
- Bacteriological culture and identification of microbial isolates.
Main Results:
- The most frequent isolates included viridans streptococci, Pseudomonas aeruginosa, nonhemolytic Streptococcus, and Staphylococcus aureus.
- Nearly all positive cultures (all but one) were polymicrobial.
- No correlation was found between the amount of granulation tissue and the duration of stenting.
- A decrease in granulation tissue and microbial load was observed after stent removal.
Conclusions:
- Polymicrobial bacterial colonization is characteristic of granulation tissue in LTR patients with Teflon stents.
- Teflon stent removal leads to a reduction in both granulation tissue and bacterial burden.
- Further prospective studies are warranted to determine optimal antimicrobial strategies for managing granulation tissue in LTR.