Brindle C Tod, Porter Steve, Bijlani Kiran, Arumugam Sridhar, Matias Rowena, Najafi Ron, Fisher Jack
Integrated Healing Technologies, Nashville, TN.
Emery Pharmaceuticals, San Francisco, CA.
Aesthet Surg J. 2018 May 15;38(suppl_2):S52-S61. doi: 10.1093/asj/sjx229.
Ralstonia Pickettii biofilms are associated with pocket infections following breast implant surgeries. Biofilm protects bacteria most topically applied antimicrobial irrigations.
To evaluate the effectiveness of four antimicrobial solutions on the planktonic form and established biofilm of Ralstonia Pickettii grown on 3 different types of silicone breast implants.
Time kill assays at clinical concentrations of chlorhexidine gluconate, povidone iodine, triple-antibiotic solution, and a 0.025% hypochlorous acid solution stabilized in amber glass were evaluated. Normal saline was the control. Three types of silicone implants, two with a textured surface and one smooth surface, were selected. Planktonic assays were performed after implants were soaked for one, five, 30, and 120 minute time points. Biofilm assays were performed after 5 and 120 minutes of implant soak time. Both tests evaluated cell-forming units (CFU/mL).
Triple antibiotic solution had no effect on R. pickettii and was dropped from the study. Remaining solutions showed total kill of planktonic bacteria at one minute. Saline control showed no significant effect on biofilm as anticipated. Stabilized hypochlorous acid was the only solution tested capable of eradicating R. pickettii biofilm on all implant surfaces tested within the first five minute soak time.
Noncytotoxic, 0.025% hypochlorous acid in normal saline, stabilized in amber glass, successfully eradicated Ralstonia pickettii in planktonic and mature biofilm on three types of silicone implants during initial five minute soak time and may be the preferred antimicrobial solution for pocket lavage. This preliminary study requires further investigation. Leaching and implant compatibility testing is currently in progress.
皮氏罗尔斯顿菌生物膜与乳房植入手术后的囊袋感染有关。生物膜可保护细菌免受大多数局部应用的抗菌冲洗液的影响。
评估四种抗菌溶液对在三种不同类型硅胶乳房植入物上生长的皮氏罗尔斯顿菌浮游形式和成熟生物膜的有效性。
评估了临床浓度的葡萄糖酸氯己定、聚维酮碘、三联抗生素溶液和一种在琥珀色玻璃中稳定的0.025%次氯酸溶液的杀菌试验。生理盐水作为对照。选择了三种类型的硅胶植入物，两种表面有纹理，一种表面光滑。在植入物浸泡1、5、30和120分钟时间点后进行浮游试验。在植入物浸泡5和120分钟后进行生物膜试验。两项试验均评估了菌落形成单位（CFU/mL）。
三联抗生素溶液对皮氏罗尔斯顿菌无效，因此从研究中剔除。其余溶液在1分钟时显示对浮游细菌有完全杀灭作用。生理盐水对照如预期的那样对生物膜没有显著影响。稳定的次氯酸是唯一一种在浸泡前五分钟内能够在所有测试的植入物表面根除皮氏罗尔斯顿菌生物膜的测试溶液。
在琥珀色玻璃中稳定的生理盐水中的无细胞毒性的0.025%次氯酸在最初五分钟浸泡时间内成功根除了三种类型硅胶植入物上的浮游和成熟生物膜中的皮氏罗尔斯顿菌，可能是囊袋冲洗的首选抗菌溶液。这项初步研究需要进一步调查。浸出和植入物相容性测试目前正在进行中。
