Reischies Frederike M J, Krause Robert, Holzer Judith, Tiefenbacher Fabian, Winter Raimund, Eylert Gertraud, Meikl Tobias, Tuca Alexandru, Köfer Martin J, Kamolz Lars P, Lumenta David B
Department of Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Medical University of Graz, Graz, Austria.
Department of Internal Medicine, Section of Infectious Diseases and Tropical Medicine, Medical University of Graz, Graz, Austria.
PLoS One. 2017 Aug 10;12(8):e0182267. doi: 10.1371/journal.pone.0182267. eCollection 2017.
Different research groups have identified microorganisms on breast implants by sonication with significant correlation to the rate of capsular contracture. This substantiated the hypothesis of an infectious etiology of capsular contracture. However, no clinical consequence has been drawn from these results yet. Aim of this study was to review sonication results from breast implants and to evaluate the current preoperative antibiotic regime for breast-implant surgery.
We compared breast implant sonication culture results from published reports and our own database. Current perioperative antibiotic recommendations were compared with the susceptibility profile of the found organisms.
We found Coagulase-negative staphylococci and Propionibacteria to be the main group of microorganism found by sonication on explanted breast implants. Most guidelines recommend cephalosporins for preoperative antibiotical prophylaxis for breast-implant surgery.
There is a discrepancy between antibiotic activity of commonly used antibiotics for preoperative prophylaxis of surgical site infections, and microorganisms found by sonication on breast implants, suspected to trigger the formation of capsular contracture. A targeted antibiotic prophylaxis for breast implant surgery with glycopeptides (e.g. Vancomycin) should be considered for the prevention of capsular contracture.
不同研究小组通过超声处理在乳房植入物上鉴定出微生物，且与包膜挛缩率存在显著相关性。这证实了包膜挛缩的感染病因假说。然而，尚未从这些结果中得出临床结论。本研究的目的是回顾乳房植入物的超声处理结果，并评估当前乳房植入手术的术前抗生素方案。
我们比较了已发表报告和我们自己数据库中的乳房植入物超声培养结果。将当前围手术期抗生素推荐与所发现微生物的药敏谱进行比较。
我们发现凝固酶阴性葡萄球菌和丙酸杆菌是通过超声处理在取出的乳房植入物上发现的主要微生物类别。大多数指南推荐使用头孢菌素进行乳房植入手术的术前抗生素预防。
用于手术部位感染术前预防的常用抗生素的抗菌活性与通过超声处理在乳房植入物上发现的、疑似引发包膜挛缩形成的微生物之间存在差异。应考虑使用糖肽类抗生素（如万古霉素）进行乳房植入手术的针对性抗生素预防，以预防包膜挛缩。
