Bacteria and Granulation Tissue Associated With Montgomery T‐Tubes

Abstract

Granulation tissue commonly occurred next to the silicone (subglottic area, stoma) where S aureus and P aeruginosa were commonly isolated. A combination of mechanical irritation and bacterial infection seems to account for the development of granulation tissue. Polymerase chain reaction fingerprinting showed both prolonged persistence and a change of colonizing strains after multiple stent replacements. A combination of amoxicillin-clavulanate and ofloxacin is the most effective antibiotic therapy. Sterilization of the cost-intensive silicone stents is feasible, and reuse in the same patient is justifiable from economic aspects.

Respiratory Infections Increase the Risk of Granulation Tissue Formation Following Airway Stenting in Patients With Malignant Airway Obstruction

“…16,23,24 Histologic studies of stents have shown a nonspecifi c infl ammatory response without foreign-body giant cells. 16,24,25 Presumably, stents with higher migration rates also have a higher degree of motion, putting them at increased risk for developing granulation tissue. This is consistent with our observation that silicone stents have a higher incidence of both migration and granulation.…”

“…[14][15][16]23 In a dog model, trauma alone was insuffi cient to induce granulation tissue, but trauma and bacterial contamination led to granulation tissue. 15 Human studies have shown an association between positive cultures and the presence of granulation tissue, 14,16,23 and airway build-up. Whether this coating affects infection rates warrants further investigation.…”

“…We hypothesized that different stent types would have different incidence rates of infection and that infection would lead to the development of granulation tissue. [14][15][16] …”

Tracheal Wall Thickening Is Associated with the Granulation Tissue Formation Around Silicone Stents in Patients with Post-Tuberculosis Tracheal Stenosis

“…Previous studies reported that granulation tissues in the tracheobronchial tree are associated with airway infection, stimuli from a foreign body (including an airway stent) or excessive radial force to trachea induced by an airway stent 7,8,11,12. However, little information is available on the risk factors of granulation tissue formation after airway stenting.…”

“…Airway restenosis caused by granulation tissue formation occurs in nearly 40-71% of patients who receive silicone stent placement 7,8. Thus, it is necessary to ascertain associated factors for granulation tissue formation in PTTS patients.…”