Abstract
Infection following rhino-prosthesis surgery poses a significant challenge, with primary treatment strategies centered on identifying specific pathogenic bacteria through bacterial culture and administering effective antibiotics. This study aimed to investigate whether conducting bacterial cultures that specifically target the nasal prosthesis could provide more objective guidance for clinical decision-making. We included patients who developed infections subsequent to prosthesis rhinoplasty in this investigation. The clinical significance of bacterial cultures obtained from nasal prostheses was assessed by comparing the culture results with those derived from the nasal mucosa or secretions from disrupted wounds. Notably, the bacterial detection rate in samples taken from prosthetic devices was significantly higher than that observed in conventional specimens from the same patients, exhibiting a statistically significant difference. Within the prosthetic group, no statistically significant difference was identified in bacterial detection rates between patients who received antibiotics 3 days prior to surgery and those who did not. In contrast, in the conventional control group, there was a marked decrease in bacterial detection rates among patients following antibiotic administration. Among patients treated with antibiotics, the detection rate of bacteria cultured from prosthetic specimens was significantly higher compared to that in the control group; however, there were no statistical differences found regarding bacterial detection rates for those not treated with antibiotics. In analyzing materials within the prosthesis group: silicone implants showed a bacterial detection rate of 80%, expanded polytetrafluoroethylene materials had a rate of 79.2%, and other materials demonstrated a 90.9%rate. No statistically significant differences were noted among these three material types within this cohort. In contrast, within the control group: silicone implants exhibited a bacterial detection rate of 66.7%, expanded polytetrafluoroethylene materials registered at 73.6%, while other materials maintained a lower count at 63.6%. Similarly, no statistically significant differences prevailed among these groups. Culturing prosthetic specimens can enhance the detection rate of bacteria, particularly in patients who have received antibiotic therapy prior to surgery, offering distinct advantages. Therefore, we advocate for the implementation of prosthetic specimen cultures as an adjunctive measure for detecting infections post-nasal prosthesis reconstruction. Among patients treated with antibiotics, the rate of bacteria detected from cultured prosthetic specimens was significantly higher compared to that in the control group. However, no statistically significant differences were observed regarding bacterial detection rates in patients not receiving antibiotic treatment. When analyzing materials within the prosthesis group: silicone implants exhibited a bacterial detection rate of 80%, expanded polytetrafluoroethylene (ePTFE) materials had a detection rate of 79.2%, and other materials demonstrated a higher rate of 90.9%. Notably, there were no statistically significant differences among these three material types within this cohort. In contrast, within the control group: silicone implants displayed a bacterial detection rate of 66.7%, ePTFE materials showed a rate of 73.6%, while other materials recorded a lower count at 63.6%. Similarly, no statistically significant differences emerged among these groups. Culturing prosthetic specimens can enhance the detection rates of bacteria, particularly in patients who have undergone antibiotic therapy prior to surgery, thereby offering distinct advantages for infection diagnosis. Therefore, we advocate for incorporating cultures of prosthetic specimens as an adjunctive measure for detecting infections following nasal prosthesis reconstruction.Level of evidence: Level 4.