PDF(Pubmed)
Abstract：
Background/Objectives: In oral and maxillofacial surgery, the reconstruction of defects often involves the transfer of skin tissue into the oral cavity utilizing microvascular grafts. This study investigates postoperative changes in microbial colonization following intraoral microvascular transplantation, as well as potential influencing factors. Methods: In 37 patients undergoing intraoral reconstructions, pre- and postoperative swabs were taken from the donor and recipient regions to quantify the seven selected marker bacteria using TaqMan PCRs. Patient-specific factors and clinical data were also recorded. Results: The infection-associated Acinetobacter baumannii tended to decrease postoperatively, while the infectious pathogens Pseudomonas aeruginosa, Enterococcus faecalis and the family of Enterobacteriaceae showed a postoperative increase without being directly associated with a clinical infection. Streptococcus mitis showed a significant postoperative decrease on buccal mucosa and increase on the graft surface (oral dysbiosis) and was significantly reduced or displaced by other bacteria (e.g., Mycoplasma salivarium, positive selection) when treated with ampicillin/sulbactam. Conclusions: The cutaneous microbiome of the graft adapts to the local intraoral environment. Postoperative shifts in oral bacterial colonization and an increase in infection-relevant bacteria were observed. These perioperative changes in colonization are also influenced by the administration of ampicillin/sulbactam. Consequently, single doses of antibiotics appear to be more beneficial compared to longer-term preventive use.
摘要：
背景/目标：在口腔颌面外科，缺损的重建通常涉及利用微血管移植物将皮肤组织转移到口腔中。这项研究调查了口腔内微血管移植后微生物定植的术后变化，以及潜在的影响因素。方法：在37例接受口内重建的患者中，使用TaqManPCRs从供体和受体区域采集术前和术后拭子以定量7种选定的标记细菌。还记录了患者特异性因素和临床数据。结果:感染相关鲍曼不动杆菌术后呈下降趋势,而传染性病原体铜绿假单胞菌，粪肠球菌和肠杆菌科显示术后增加，而与临床感染没有直接关系。链球菌在颊粘膜上显示出显着的术后减少，在移植物表面（口腔菌群失调）增加，并且被其他细菌显着减少或取代（例如，唾液支原体，阳性选择）用氨苄西林/舒巴坦治疗时。结论：移植物的皮肤微生物组适应局部口腔内环境。术后观察到口腔细菌定植的变化和感染相关细菌的增加。这些围手术期定植的变化也受到氨苄西林/舒巴坦的影响。因此,与长期预防性使用相比,单剂量抗生素似乎更有益.
