Biofilms in Cosmetic Surgery

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        Biofilm update

        New evidence helps to confirm that biofilms have been shown to cause health issues in plastic surgery procedures; mainly, breast implant related capsular contracture. Biofilms could also be linked to latent post soft tissue filler infections and granulomas.

        Contracture around breast implants is the most common medium- to long-term complication following breast augmentation, said Anand Deva, B.Sc., M.B.B.S., M.S., F.R.A.C.S., associate professor, Macquarie Cosmetic and Plastic Surgery and head of the Surgical Infection Research Group, Macquarie University, Sydney.

        “There is now clear evidence that bacteria can attach to the surface of breast implants at the time of surgery to form a biological coating (biofilm), which can go on to cause inflammation and contracture,” Professor Deva said. “We are now working on strategies to prevent bacterial access to implants at the time of surgery and early results are very promising.”

        Professor Deva and his group have been looking at the issue of biofilm and prosthetics for more than a decade.

        “We have used basic scientific investigation, field studies of patients with failed prosthetics and laboratory models to show conclusively that biofilm is the single most important cause of prosthetic failure in medicine,” he said. “The range of prosthetics is vast — from orthopaedic pins, artificial heart valves, replacement knees and hips and even contact lenses. For cosmetic surgery, our focus has been on breast implants. More recently we have also turned our attention to the problem of biofilm in injectable fillers.”

        In a study funded by the Aesthetic Surgery Education and Research Foundation, Professor Deva and colleagues looked at currently unapproved antibiotic impregnated bioabsorbable polymer, which could help prevent biofilm formation, Dr. Adams said.

        This product essentially is an absorbable piece of mesh, impregnated with antibiotics and implanted with the breast implant to sterilize the pocket, Dr. Adams said. In a pig model, the researchers showed all of 14 of the animals that had the implants without the product developed capsular contracture, while none of the 14 that had the product developed the contracture.

        “I think it has become mainstream thinking that bacteria and biofilms are the leading cause of capsular contracture. This is important research because we’re going to need to develop strategies to prevent the formation of biofilms to reduce morbidity,” Dr. Adams said.

        Source: ModernMedicine – Medical Resource, Medical Information, Medical Articles

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