Department of Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago2currently in private practice, Atlanta, Georgia.
Department of Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago.
JAMA Facial Plast Surg. 2016 Jul 1;18(4):299-304. doi: 10.1001/jamafacial.2016.0279.
Alloplastic implants are widely used in facial plastic surgery, both in rhinoplasty and nonrhinoplasty procedures. Implant infection and extrusion are significant concerns of such implants after placement. Bacterial biofilms have been previously implicated in chronic wound infections, particularly in the presence of foreign bodies, such as alloplastic facial implants. Owing to their structural composition, biofilms are resistant to treatment with conventional antibiotics, and implant removal is frequently the only option.
To evaluate explanted alloplastic facial implants for the presence or absence of bacterial biofilm using scanning electron microscopy.
DESIGN, SETTING, AND PARTICIPANTS: Facial implants explanted by a single surgeon were analyzed for biofilm formation between July 1, 2012, and June 30, 2013. Of 7 facial implants, 4 consisted of silicone, and 3 were porous polyethylene. Six of the 7 were nasal dorsal implants, and 1 silicone implant was removed from the midface. Nonexplanted fresh silicone and porous polyethylene implants were each used as a control.
Scanning electron microscopy images were analyzed by an electron microscopist masked to the clinical history and implant type. The presence of biofilm formation was graded as none, mild, moderate, or severe.
A total of 7 patients with previously placed alloplastic facial implants at an outside institution underwent revision rhinoplasty and removal of facial implants. All porous polyethylene implants showed biofilm formation to various degrees. Furthermore, all porous polyethylene implants had at least some areas of severe biofilm formation. One of the 3 porous polyethylene implants demonstrated severe biofilm formation on the entire implant, and the other 2 porous polyethylene implants showed areas of mild and severe biofilm formation. The only 2 implants without any evidence of biofilm were silicone implants. Of the other 2 silicone implants, 1 demonstrated no biofilm formation in 1 area and severe biofilm formation in another area, whereas the other had areas of moderate and severe biofilm formation.
Five of 7 explanted facial implants showed at least some degree of biofilm formation. All implants with rougher surfaces, namely, porous polyethylene implants, demonstrated biofilm formation to a severe degree. Those with smoother surfaces, namely, silicone implants, were the only ones on which biofilm formation was either absent or less severe. Therefore, the suspicion that biofilms can form on facial implants is established through this investigation.
NA.
在面部整形手术中，包括隆鼻术和非隆鼻术，广泛使用了同种异体植入物。植入物感染和挤出是此类植入物放置后的重要关注点。细菌生物膜先前与慢性伤口感染有关，尤其是在存在异物（如同种异体面部植入物）的情况下。由于其结构组成，生物膜对常规抗生素的治疗具有抗性，并且经常需要进行植入物去除。
使用扫描电子显微镜评估同种异体面部植入物中是否存在细菌生物膜。
设计、地点和参与者：2012 年 7 月 1 日至 2013 年 6 月 30 日，对一位外科医生植入的面部植入物进行了分析，以评估生物膜的形成。7 个面部植入物中，4 个为硅胶，3 个为多孔聚乙烯。7 个中的 6 个为鼻背植入物，1 个硅胶植入物从中面部取出。未植入的新鲜硅胶和多孔聚乙烯植入物分别用作对照。
扫描电子显微镜图像由一位对临床病史和植入物类型不知情的电子显微镜学家进行分析。生物膜形成的存在被评为无、轻度、中度或重度。
共有 7 名曾在其他机构植入同种异体面部植入物的患者接受了修复性隆鼻术和面部植入物去除术。所有多孔聚乙烯植入物均显示出不同程度的生物膜形成。此外，所有多孔聚乙烯植入物均有至少一些严重生物膜形成的区域。3 个多孔聚乙烯植入物中的 1 个整个植入物上都有严重的生物膜形成，另外 2 个则显示出轻度和严重的生物膜形成区域。唯一没有任何生物膜证据的 2 个植入物是硅胶植入物。在另外 2 个硅胶植入物中，1 个在 1 个区域没有生物膜形成，而在另一个区域则有严重的生物膜形成，而另一个则有中度和严重的生物膜形成区域。
7 个被取出的面部植入物中有 5 个至少显示出一定程度的生物膜形成。所有表面较粗糙的植入物，即多孔聚乙烯植入物，均严重形成生物膜。那些表面较光滑的植入物，即硅胶植入物，只有在不存在或较少形成生物膜的情况下才会形成生物膜。因此，通过本研究证实了生物膜可以在面部植入物上形成的怀疑。
无。
