Role of bacterial biofilms in patients after reconstructive and aesthetic breast implant surgery.
Journal article

Role of bacterial biofilms in patients after reconstructive and aesthetic breast implant surgery.

  • Rieger UM Department of Plastic & Aesthetic, Reconstructive & Hand Surgery, St. Markus Hospital, Johann Wolfgang von Goethe University, Germany; Department of Plastic, Reconstructive & Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria.
  • Raschke GF Department of Cranio-Maxillofacial Surgery & Plastic Surgery, Friedrich Schiller University, Jena, Germany.
  • Frei R Clinical Microbiology, Laboratory Medicine, University Hospital, Basel, Switzerland.
  • Djedovic G Department of Plastic & Aesthetic, Reconstructive & Hand Surgery, St. Markus Hospital, Johann Wolfgang von Goethe University, Germany; Department of Plastic, Reconstructive & Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria.
  • Pierer G Department of Plastic, Reconstructive & Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria.
  • Trampuz A Center for Musculoskeletal Surgery, Charité - University Medicine Berlin, Berlin, Germany.
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  • 2014-10-02
Published in:
  • Journal of long-term effects of medical implants. - 2014
English INTRODUCTION
Capsular contracture is a feared complication following both reconstructive and aesthetic breast surgery. The etiology is uncertain, but bacterial biofilms have been suggested as trigger for chronic peri-implant inflammation, eventually leading to capsular contracture.


METHODS
Data were extracted from patient records included in a prospective cohort between 2008 and 2010. We compared patients who underwent submuscular breast reconstruction using expander implants and those needing implant removal for capsular contracture after aesthetic submuscular breast augmentation.


RESULTS
Of 36 included breast implants from 27 patients, 18 implants were inserted for reconstructive reasons and 18 for aesthetic reasons. The median indwelling time was 3 years for aesthetic implants and 3 months for reconstructive expanders. Overall, sonication cultures were positive in 13 implants (36%). In aesthetic implants, sonication cultures were positive in 28% and sonication cultures were positive in expander implants in 44%. Propionibacterium acnes and coagulasenegative staphylococci were predominant.


CONCLUSION
Sonication cultures were positive in approximately 33% of removed breast implants and were comparable for reconstructive expander and aesthetic implants. These findings support the hypothesis that bacterial biofilms play a role in the pathogenesis of capsular contracture, especially after expander reconstruction, as these implants are at the highest risk of contamination during repeated implant-filling procedures.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://sonar.ch/global/documents/269943
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