[Contamination of surgical wound during tracheal resection depending on the mode of mechanical ventilation]

Area of Science:

• Surgical Oncology
• Respiratory Medicine
• Infectious Disease

Background:

• Surgical site contamination is a concern in tracheal resection procedures.
• Mechanical ventilation is a critical component of respiratory support during and after surgery.
• Understanding ventilation's impact on wound contamination is crucial for preventing complications.

Purpose of the Study:

• To investigate the relationship between mechanical ventilation modes and surgical wound contamination during tracheal resection.
• To quantify bacterial contamination levels across different ventilation strategies.

Main Methods:

• A study involving 976 patients undergoing circular tracheal resection (396 patients).
• Bacteriological examination of surgical wounds before tracheotomy and after anastomosis formation.
• Comparison of contamination levels based on different mechanical ventilation methods, including apneic oxygenation, volumetric mechanical ventilation, high-frequency mechanical ventilation, and hypnotic mechanical ventilation.

Main Results:

• Surgical field was sterile before tracheotomy but contaminated in all patients post-tracheotomy.
• Apneic oxygenation demonstrated 100 times less contamination than volumetric or high-frequency mechanical ventilation.
• Hypnotic mechanical ventilation also showed minimal species of pathogenic microorganisms.

Conclusions:

• While wound contamination was observed in all cases, it did not directly correlate with local purulent-inflammatory processes.
• Adherence to preventive measures remains essential despite the observed contamination levels.