QUALITATIVE AND QUANTITATIVE COMPOSITION OF INJURED AREA OF ORAL CAVITY IN PATIENTS WITH FRACTURES OF THE LOWER MANDIBLE

Nahirniy Ya. P., Pokryshko O. V.

CONTENTS

Scentific article

Introduction. The species composition of microbial associations oral largely determines the course of healing of postoperative wounds. Usually the bacteria in the mouth are in dynamic equilibrium with the protective forces of the organism, and violation of this balance leads to the emergence of various kinds of complications. Among the factors that break this balance is a traumatic injury in the area of fracture of the mandible, since they reduce the resistance, and, consequently, increases the aggressiveness of microorganisms. The purpose of the study – explore the features of microbial associations of oral mucosa in the region of the fracture for the immobilization of the mandibles. Object and methods. To achieve the purpose were examined 13 the affected with traumatic open mandibles fractures, who were treated with the use of dental tires. Research conducted in the first 3 days before immobilization. The age of patients was 19-34 years. Patients, who haven’t in a mouth orthopedic structure, have been selected to study. Collecting material from the wound area of fracture was performed with sterile cotton swab. Crops were carried out by the method of crop sector method (Gould) in dense medium, which made it possible to identify the maximum possible range of aerobic and facultative anaerobic microorganisms and to determine the degree of microbial contamination. After 24-48 hours of incubation at the optimum temperature of 37 ° C, counted the number of colonies that grew, and the result reflected the number of colony forming units (CFU) per 1 ml of wound contents. Identification of isolates was performed according to Burge determinant bacteria. The study was conducted at the microbiology and parasitology research laboratory of Horbachevsky Ternopil State Medical University. Results and discussion. The microbiological studies of wound microbiota in patients with traumatic open frac-tures showed, that the majority of microorganisms belong to facultative anaerobic. Composition of microorganisms in the wound area of the fracture wore polymicrobial nature. In 84. 62% of patients allocated to the association of microorganisms that have been submitted by various populations of bacteria and fungi. Among them two-tiered as-sociation microorganisms (in 46. 15% of the surveyed people). In 38. 47% of patients cultured ternary association in 15. 38% of cases allocated to members of a certain type of microorganisms. Bacterial and fungal associations constituted 61,54%, and in most cases they were ternary. Most of the isolated microorganisms colonize the mu-cosa in the area of the fracture of the mandible at clinically relevant concentrations. The average level of coloniza-tion by microorganisms wound surface was 5. 47 2. 14 CFU / ml. The highest level of contamination was typical for the populations of E. coli (6. 72±3. 1°CFU / ml), which is representative of the transient flora and pathogenic -hemolytic streptococci (6. 62 CFU / ml). Conclusions. The results of the survey indicate that the microflora, which colonized the mucosa in the area of fracture was polymicrobial in nature, mainly in the form of 2-or three-component associations in clinically relevant concentrations. Prospects for further researches. Development of an antiseptic for rehabilitation of the mouth, which have a selective effect on pathogens and does not reduce the population level representatives of normal microflora.

traumatic fracture of the mandible, microflora, qualitative and quantitative composition

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