Aesthet Surg J. 2024 May 15;44(6):605-611. doi: 10.1093/asj/sjae013.
Bacterial contamination of implants has been linked to biofilm formation and subsequent infection, capsular contracture, and breast implant-associated anaplastic large cell lymphoma. Reducing contamination during implant insertion should therefore reduce biofilm formation disease sequelae.
The aim of this study was to compare levels of contamination between preventative techniques.
A model to simulate the passage of implants through a skin incision was designed that utilized a sterile textured polyvinyl plastic sheet contaminated with Staphylococcus epidermidis. In the first stage of the polyvinyl contamination model, implants were subject to infection-mitigation techniques and passed through the incision, then placed onto horse blood agar plates and incubated for 24 hours. In the second stage of the study the same contamination was applied to human abdominal wall specimens. A 5 cm incision was made through skin and fat, then implants were passed through and levels of contamination were measured as described.
Smooth implants grew a mean of 95 colony-forming units (CFUs; approximately 1 CFU/cm2) and textured implants grew 86 CFUs (also approximately 1 CFU/cm2). CFU counts were analyzed by the Mann-Whitney U-test which showed no significant difference between implant types (P < .05); independent-sample t-tests showed a significant difference. The dependent-variable techniques were then compared as groups by one-way analysis of variance, which also showed a significant reduction compared with the control group (P < .01).
This in vitro study has shown the effectiveness of antiseptic rinse and skin/implant barrier techniques for reducing bacterial contamination of breast implants at the time of insertion.
植入物的细菌污染与生物膜形成以及随后的感染、包膜挛缩和乳房植入物相关间变性大细胞淋巴瘤有关。因此，在植入物插入过程中减少污染应能减少生物膜形成的疾病后果。
本研究旨在比较预防技术之间的污染水平。
设计了一种模拟植入物通过皮肤切口的模型，该模型使用受表皮葡萄球菌污染的无菌纹理聚氯乙烯塑料片。在聚氯乙烯污染模型的第一阶段，植入物采用感染缓解技术通过切口，然后放置在马血琼脂平板上孵育 24 小时。在研究的第二阶段，相同的污染应用于人体腹壁标本。通过皮肤和脂肪做一个 5cm 的切口，然后将植入物穿过切口，并按所述方法测量污染水平。
光滑植入物的平均菌落形成单位（CFU）为 95 个（约 1 CFU/cm2），纹理植入物为 86 个 CFU（也约为 1 CFU/cm2）。CFU 计数采用 Mann-Whitney U 检验进行分析，结果显示植入物类型之间无显著差异（P <.05）；独立样本 t 检验显示有显著差异。然后通过单因素方差分析将依赖变量技术作为组进行比较，结果也显示与对照组相比有显著降低（P <.01）。
本体外研究表明，在植入物插入时，使用抗菌冲洗和皮肤/植入物屏障技术可有效减少乳房植入物的细菌污染。
