Bacterial biofilms and capsular contracture in patients with breast implants

Rieger, Ulrich M.; Mesina, J.; Kalbermatten, Daniel F.; Haug, Martin; Frey, Hilde; Pico, R Aguilar; Frei, Reno; Pierer, Gerhard; Lüscher, N. J.; Trampuž, Andrej

doi:10.1002/bjs.9084

Cited by 205 publications

(121 citation statements)

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“…In addition, since experimental models are rarely able to replicate the development of capsular contracture, most studies evaluate the outcome of different interventions on normal capsule formation in their animal models (Vieira et al 2010, Dobke et al 1995, Rieger et al 2013, Bastos et al 2003, 2007a, Imber et al 1974, Ksander et al 1981, Peters et al 1980, Chelko et al 2012, Aparecida da Silva et al 2014, Shin et al 2013, Uzunismail et al 2008, Chang et al 1992, Hester et al 1988, Asplund et al 1996, Thuesen et al 1995, Puckett et al 1987, Hakelius and Ohlsen 1997, Handel et al 1995, Lemperle and Exner 1993, Zimman 2007, Bergmann et al 2012, Hester et al 2001, Lilla and Vistes 1976, Brand 1984. This fact understates the impact of conclusions from previous studies, since therapy should be focused in pathologic capsule formation.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies also evidence the link between subclinical infection and capsular contracture occurrence (Bergmann et al 2014, Del Pozo et al 2009, Dobke et al 1995. In the same line, many studies support that bacterial biofilms on breast implants, most commonly formed by Staphylococcus epidermidis, can promote chronic inflammation, and stimulate fibrosis and capsular contracture (Rieger et al 2013, van Heerden et al 2009, Dobke et al 1995, Netscher 2004 (Mendes et al 2008). Therefore, the possible relationship of bacterial infection and capsular contracture occurrence needs further study.…”

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confidence: 99%

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Capsular Contracture In Silicone Breast Implants: Insights From Rat Models

Vieira

d'Acâmpora

Neves

et al. 2016

An. Acad. Bras. Ciênc.

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Breast augmentation with silicone implants is one of the most common procedures performed by plastic surgeons around the world. Capsular contracture is a frequent complication in breast augmentation and reconstructive surgery, that requires invasive intervention. The inflammatory response to implanted mammary prostheses appears to be directly associated to capsular contracture. This review discusses the evidences from rat models studies, on the role of inflammation and fibrosis in capsular contraction and its relation to silicone breast implants surface.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Capsular Contracture In Silicone Breast Implants: Insights From Rat Models

Vieira

d'Acâmpora

Neves

et al. 2016

An. Acad. Bras. Ciênc.

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“…In this cancer type, opportunistic pathogens form polymicrobial biofilm on local mucosa, contributing to CRC progression. Studies have shown that there exists a metabolic association between biofilm and CRC (22).…”

Section: Biofilms In Medical Scenariomentioning

confidence: 99%

“…They can directly colonize human surfaces or they colonize medical devices and contaminate patients that depend of such devices as catheters, endotracheal tubes, joint implants, breast implants and others (21)(22)(23)(24). The biofilm formed in these devices serves as a source of pathogenic microorganisms that may cause acute or chronic infections.…”

Section: Biofilms In Medical Scenariomentioning

confidence: 99%

Metagenomic approach to study biofilm in medical context

Ribeiro

Castro

Franco

2017

MRAJ

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Microbial organization in biofilms plays an important role in health and disease. This microbial lifestyle can protect its host against pathogens and contribute to the metabolism of nutrients. On the other hand, pathogenic biofilms can increase the morbidity and mortality of patients, raising the economic cost of infections. Here, we describe how biofilm is organized, its role in different scenarios in the human body and discuss how metagenomic studies has contributed to understand the microbial diversity that interact with the host. It is currently known that many biofilms in the human body may have a polymicrobial composition. In the context of infectious diseases, this composition may limit therapeutic approaches to combat biofilms even more. Thus, describing microbial diversity could help to guide therapeutic decisions.

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“…The lack of attention to asepsis measures in invasive procedures or surgery is another common risk factor for late infections. The microorganisms involved can be both Gram-positive and Gram-negative, but coagulasenegative staphylococci and Propionibacterium acnes are the most common [32]. The symptoms of late infections are less pronounced than those of acute infections: delayed wound healing, not marked breast pain, mildly erythematous skin, slightly warm and stretched skin, drainage not always present and not purulent, and prosthesis dislocation.…”

Section: Late Infectionsmentioning

confidence: 99%

Infections in breast implants: a review with a focus on developing countries

Rubino

Brongo

Pagliara

et al. 2014

J Infect Dev Ctries

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The risk of surgical site infection is always present in surgery; the use of prosthetic materials is linked to an increased possibility of infection. Breast augmentation and breast reconstruction with implants are gaining popularity in developing countries. Implant infection is the main complication related to breast aesthetic and reconstructive surgery. In the present paper, we reviewed the current microbiological knowledge about implant infections, with particular attention to risk factors, diagnosis, clinical management, and antibiotic prophylaxis, focusing on reports from developing countries. After breast aesthetic surgery, up to 2.9% of patients develop a surgical site infection, with an incidence of 1.7% for acute infections and 0.8% for late infections. The rate of surgical site infection after post-mastectomy breast reconstruction is usually higher, ranging from 1% to 53%. The clinical features are not constant, and bacterial culture with antibiogram is the gold standard for diagnosis and for identification of antibiotic resistance. While waiting for culture results, empiric therapy with vancomycin and extendedspectrum penicillins or cephalosporins is recommended. Some patients require removal of the infected prosthesis. The main methods to bring down the risk of infection are strict asepsis protocol, preoperative antibiotic prophylaxis, and irrigation of the surgical pocket and implant with an antibiotic solution.Key words: breast implant infections; acute infections; late infections; fungal infections; rare infections. EpidemiologyImplant infection is the main complication related to breast aesthetic and reconstructive surgery [1]. After breast aesthetic augmentation, up to 2.9% of women are affected by infection [2], with an incidence of 1.7% for acute infections versus an incidence of 0.8% for late infections, as confirmed by retrospective cohort studies with long-term follow-ups [1]. In developing countries, this problem is even more prevalent; surgery has a 50% rate of possible complications, of which infection is the main complication [3]. The rate of surgical site infection after post-mastectomy breast reconstruction is usually higher, ranging from 1% to 53% [4,5]. In breast reconstruction, a higher rate of infection was reported with expander implants compared to reconstruction with autologous tissue such as latissimus dorsi flaps [6]. The highest rates were found in women undergoing immediate reconstruction [4]. The reported number of infections after mammary augmentation and reconstruction is lower than the real incidence, because of the lack of a surveillance network of patients based on long-time follow-ups. The economic commitment for management of implant infections is significant. Kirkland et al. [7] reported an increase of hospital permanence for surgical site infection of 6.5 days, with related health care costs. In the United States, health care costs for surgical site infection after breast surgery were estimated to be about $4,091 [7], or $574 in the outpatient setting [9]...

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Bacterial biofilms and capsular contracture in patients with breast implants

Abstract: NCT01138891 (http://www.clinicaltrials.gov).

Cited by 205 publications

References 50 publications

Capsular Contracture In Silicone Breast Implants: Insights From Rat Models

Capsular Contracture In Silicone Breast Implants: Insights From Rat Models

Metagenomic approach to study biofilm in medical context

Infections in breast implants: a review with a focus on developing countries

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