Management of Accidentally Contaminated Buccal Mucosa Grafts.

OBJECTIVE

To evaluate the microbiological contamination of accidentally contaminated buccal mucosa grafts and determine the effectiveness of 2% chlorhexidine (CHX) cleansing as a decontamination method, as well as to assess the impact of intraoperative irrigation with 0.1% gentamicin solution on the prevention of surgical site infection (SSI).

METHODS

Prospective descriptive study conducted in consecutive patients undergoing urethral surgery with buccal mucosa grafts (BMGs). From each patient, 4 graft segments (2×6-10 mm) were obtained: baseline microbiota (F1); contamination after 3-minute floor exposure (F2); contamination after floor exposure followed by CHX cleansing (F3); and a final sample collected after graft placement and exposure to standard gentamicin irrigation (F4). Microbiological cultures were performed for all fragments.

RESULTS

Twenty patients met the inclusion criteria (1 female, 5%). Baseline flora (F1) was identified in 13 cases (65%), exclusively oral commensals. F2 samples were positive in 15 cases (75%) but showed no pathogenic microbes. CHX cleansing (F3) achieved complete eradication in all samples. F4 showed 6 positive cases (30%), again limited to oral commensals despite gentamicin exposure. No SSI occurred during a mean 6-month follow-up.

CONCLUSION

BMGs dropped to the floor were not contaminated with pathogenic bacteria. CHX was highly effective for decontamination. Irrigation with gentamicin solution did not significantly reduce commensal colonization or the incidence of SSI in this series. Appropriately cleansed accidentally contaminated BMGs may be safely reused.