The Ever-Changing Role of Biofilms in Plastic Surgery

Abstract

The goal of this article is to present a brief background of biofilms and how they pertain to plastic surgery. Of particular interest are how biofilms affect breast prosthesis and their subsequent complications. The authors also present information on how biofilms are involved in soft-tissue filler complications. After a brief review of the pathophysiology of biofilms and their effect on plastic surgery, the authors propose a revised algorithm to assist in guiding the plastic surgeon when faced with complications that involve biofilms that involves more rapid diagnosis and treatment using polymerase chain reaction technology. This article is a review of recent literature.

Microbial biofilm in human health - an updated theoretical and practical insight

“…In order to support a more rapid diagnosis of biofilm-related infectious complications by PCRbased methods, Ryan S. et al proposed a revised algorithm, to guide the plastic surgeon when facing complications that involve biofilms. They have highlighted that the management of recurrent capsular contracture in breast augmentation and biofilm reaction to soft-tissue fillers are important examples of how rapid polymerase chain reaction technology can contribute to build up a clinical algorithm for care that will help to choose a specific targeted antibiotic treatment (8).…”

“…To sum up, the main stages of biofilm initiation and development may be defined as follows: microbial adherence, colony formation, biofilm maturation and final dispersion (Figure 1). During each of these stages, microorganisms may benefit from internal or external supportive structures (pili, DNA or exopolysaccharides) (1,2,3,7,8).…”

A Formidable Foe Is Sabotaging Your Results: What You Should Know about Biofilms and Wound Healing

“…Biofilm can form in the context of a number of tissue types in the body including wounds, the respiratory and sinus tracts, gastrointestinal mucosa as well as on implantable and injectable materials. Biofilm is implicated in a number of disease states including implant-associated infections, otitis media, cystic fibrosis, bacterial endocarditis, infectious nephrolithiasis as well as osteomyelitis and problems wounds [3, 19, 21-24]. …”

Adverse Reactions to Injectable Fillers

“…49 They are prevalent and pervasive in the medical field, are thought to be responsible for up to 80% of all infections, and cost more than $1 billion annually. 50 Analogous to other prostheses and implants, soft-tissue fillers (especially the long-lasting and permanent fillers) also have the potential for biofilm formation, and this may play a role in many delayed-onset skin reactions. This issue may be magnified with the introduction of newer fillers with longer duration as well as the ever-increasing popularity and use of dermal fillers, and is therefore covered in some detail here.…”