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- Title
The Value of Microbiological Screening in Cleft Lip and Palate Surgery.
- Authors
Thomas, Gregory P. L.; Sibley, Jane; Goodacre, Timothy E. E.; Cadier, Michael M.
- Abstract
Objective: This study was performed to investigate whether nasal and oropharyngeal microbiological swabs taken prior to cleft lip and palate surgery correlated with the oronasal flora at the time of surgery and whether specific culture results affected surgical outcome. Methods: Prospective audit set in two designated U.K. cleft centers each with a single surgeon. Nasal and oropharyngeal microbiological swabs were taken within 2 weeks prior to surgery and again on the operating table. Adverse outcome measures included postoperative pyrexia, wound dehiscence, or fistula formation. Results: One hundred forty-four cases were recruited over 12 months. Nasal swabs cultured organisms significantly more often than oropharyngeal swabs (p < .0001). No significant difference was detected in the number of cases with a positive microbiology culture preoperatively compared with perioperative sampling (48% and 50%). The specific organisms cultured from preoperative swabs were the same as those cultured at surgery in only half of cases. Preoperative microbiology swabs were poorly predictive of the oronasal flora at surgery. Antibiotic treatment of patients with positive preoperative microbiology did not significantly reduce the incidence of bacterial colonization or significantly alter clinical outcome. Conclusion: Preoperative microbiological investigation is not helpful in predicting the nasal and oropharyngeal flora at the time of surgery. Further, culture results did not correlate with postoperative outcome, regardless of whether pre- or perioperative antibiotic therapy was instigated. This evidence suggests that microbiology screening swabs are an unnecessary investigation.
- Subjects
UNITED Kingdom; AUDITING; CLEFT lip; CLEFT palate; FISHER exact test; LONGITUDINAL method; MEDICAL cooperation; MICROBIAL sensitivity tests; HEALTH outcome assessment; RESEARCH; STAPHYLOCOCCUS aureus; STATISTICS; STREPTOCOCCUS; EQUIPMENT &; supplies; TREATMENT effectiveness
- Publication
Cleft Palate Craniofacial Journal, 2012, Vol 49, Issue 6, p708
- ISSN
1055-6656
- Publication type
Article
- DOI
10.1597/11-063