European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 5, pp 1385–1390 | Cite as

A reliable method to avoid contamination during cartilage graft preparation in septorhinoplasty

  • Fatih ArslanEmail author
  • Duygu Ocal
  • Cemile Acikgoz Yildiz
  • Iştar Dolapci



The aim of the study is to determine the risk of contamination in the cartilage graft materials prepared on the swester table and those prepared in a sterile package, and to reveal a more reliable method by performing the microbiological examination of these materials.


Cartilages removed from the nasal septum were divided into four pieces. The first part (Sample A) was directly placed into the medium. Sample B was prepared by being crushed in a sterile package. Sample C was prepared on the auxiliary swester table, and Sample D was prepared on the main swester table actively used by surgery team. All samples were transferred in a 1 ml brain heart(BH) liquid medium. From each BH medium, 100 µl culture was performed on blood agar, eosin–methylene blue–lactose–sucrose agar and chocolate agar.


Bacterial growth was detected in 2 of the samples A, in 4 of the samples B, in 24 of the samples C, and in 36 of the samples D. The number of patients with bacterial growth in the samples C and/or D despite no growth in the sample B was 35. When the samples A/B and C/D were compared in terms of bacterial growth, a significant difference was found in all matchings (p < 0.001 for all comparisons). 


These findings showed that preparation of the cartilage grafts on the swester table was extremely risky for microbiological contamination. Arslan and his colleagues suggest that preparing a graft material in a sterile package is extremely simple, cheap, and it also reduces contamination risk significantly.


Bacterial growth Cartilage grafts Microbiological contamination Septorhinoplasty 



  1. 1.
    Cakmak O, Buyuklu F, Yilmaz Z, Sahin FI, Tarhan E, Ozluoglu LN (2005) Viability of cultured human nasal septum chondrocytes after crushing. Arch Facial Plast Surg 7(6):406–409CrossRefGoogle Scholar
  2. 2.
    Oreroğlu AR, Cakır B, Akan M (2014) Bone dust and diced cartilage combined with blood glue: a practical technique for dorsum enhancement. Aesthetic Plast Surg 38(1):90–94CrossRefGoogle Scholar
  3. 3.
    Erol OO (2000) The Turkish delight: a pliable graft for rhinoplasty. Plast Reconstr Surg 105:2229–2241CrossRefGoogle Scholar
  4. 4.
    Baran CN, Tiftikcioglu YO, Baran NK (2005) The use of alloplastic materials in secondary rhinoplasties: 32 years of clinical experience. Plast Reconstr Surg 116(5):1502–1516CrossRefGoogle Scholar
  5. 5.
    Kim SH, Tan KL, Lee SY, Kim DW, Shin S, Jin HR (2016) Effect of chlorhexidine pretreatment on bacterial contamination at rhinoplasty field. Springerplus 5(1):2116CrossRefGoogle Scholar
  6. 6.
    Binar M, Arslan F, Tasli H, Karakoc O, Kilic A, Aydin U (2015) An unusual cause of necrosis and nasal septum perforation after septoplasty: Enterobacter cloacae. New Microbes New Infect 16:8:150–153CrossRefGoogle Scholar
  7. 7.
    Dąbrowska-Bień J, Skarżyński PH, Gwizdalska I, Łazęcka K, Skarżyński H (2018) Complications in septoplasty based on a large group of 5639 patients. Eur Arch Otorhinolaryngol 275(7):1789–1794CrossRefGoogle Scholar
  8. 8.
    Arslan F, Yıldız CA (2018) A practical suggestion for prepare dorsal onlay graft. J Craniofac Surg 29(4):344–345CrossRefGoogle Scholar
  9. 9.
    EUCAST (2018) Clinical Breakpoints–Bacteria (V 8.1). Available at:
  10. 10.
    Durmaz E, Dursun E, Iriz A, Mumcuoglu I, Eryilmaz A (2011) Changes in the ocular and nasal cultures in patients who had undergone septoplasty. J Otolaryngol Head Neck Surg 40(6):493–498Google Scholar
  11. 11.
    Warnke PH, Russo PA, Hopfenziz M, Kurz B, Becker ST, Sherry E, Springer I, Sivananthan S (2010) Antimicrobial peptide immunity protects human nasal and auricular cartilage against infection. J Craniofac Surg 21(1):198–201CrossRefGoogle Scholar
  12. 12.
    Won TB, Jin HR (2010) Revision rhinoplasty in Asians. Ann Plast Surg 65(4):379CrossRefGoogle Scholar
  13. 13.
    Abifadel M, Real JP, Servant JM, Banzet P (1990) Apropos of a case of infection after esthetic rhinoplasty. Ann Chir Plast Esthet 35(5):415–417Google Scholar
  14. 14.
    Kreutzer C, Hoehne J, Gubisch W, Rezaeian F, Haack S (2017) Free diced cartilage: a new application of diced cartilage grafts in primary and secondary rhinoplasty. Plast Reconstr Surg 140(3):461–470CrossRefGoogle Scholar
  15. 15.
    Daniel RK, Calvert JW (2004) Diced cartilage grafts in rhinoplasty surgery. Plast Reconstr Surg 113(7):2156–2171CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Otolaryngology, Head and Neck SurgeryBeytepe Murat Erdi Eker State HospitalAnkaraTurkey
  2. 2.Department of Medical MicrobiologyAnkara University School of MedicineAnkaraTurkey

Personalised recommendations