Microbiological Evaluation of Cartilage Grafts Stored in Gentamicin-Diluted Saline During Rhinoplasty

Cartilage grafts are widely used in rhinoplasty; however, concerns remain regarding bacterial contamination during graft handling and storage. The authors aimed to evaluate bacterial growth in septal cartilage grafts stored in gentamicin-diluted saline solution and to investigate the relationship between storage duration, the localization of bacterial growth, and microbiological characteristics. This ambispective observational study included 94 septal cartilage grafts harvested during rhinoplasty procedures and stored under controlled conditions. Microbiological analyses were performed prospectively using standard aerobic and anaerobic culture techniques. Storage duration was defined as the interval between harvesting and culture. Culture results, bacterial species, and localization of growth (cartilage versus storage solution sediment) were recorded. Statistical analysis was performed using the Mann-Whitney U test and the Fisher exact test. Bacterial growth was detected in 18 of 94 samples (19.1%), while 76 samples (80.9%) showed no growth. Growth was more frequently observed in the storage solution sediment (n=11) than within the cartilage graft itself (n=8). Mean storage duration did not differ significantly between culture-positive and culture-negative samples (452.1 versus 418.3 d, P =0.882). Stratified analysis (<365 versus ≥365 d) also showed no significant difference in culture positivity ( P =0.613; OR=0.73). No association was observed between storage duration and the type of microorganisms. The majority of septal cartilage grafts remained culture-negative despite prolonged storage. Bacterial growth was more commonly confined to the surrounding storage solution rather than the graft itself. These findings suggest that storage in gentamicin-containing solutions may provide a microbiologically stable environment, although complete sterility cannot be guaranteed.