Karakas Ebubekir, Ayhan M Suhan, Karasu Oguzhan, Kocak Ceren Ozkul, Yalinay Meltem
Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey.
Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey.
Aesthetic Plast Surg. 2024 Dec;48(23):5007-5017. doi: 10.1007/s00266-024-04090-2. Epub 2024 May 28.
Capsular contracture is one of the most common complications after breast surgery involving silicone implants. The most likely cause of this condition is biofilm formation. In this study, the efficacy of local antibiotherapy against biofilm formation on implant surfaces was investigated.
Thirty-six rats were divided into six groups. Three pockets were created on the dorsum of each rat, and 1 × 2 cm implant surface samples from smooth, polyurethane and textured implants were randomly placed into pockets. All samples were inoculated with staphylococcus epidermidis. In groups 1-2-3, inoculated samples were placed into the pockets and removed after 1, 6 and 24 h, respectively. In groups 4-5-6, inoculated samples immersed with rifamycin were placed and removed after 1, 6 and 24 h, respectively. Bacterial load was measured with plate count method.
Bacterial load was lower in groups 4-5-6 than in groups 1-2-3 (p < 0.05). In groups 4-5-6, bacterial load was lower for polyurethane than for textured surfaces at all time points (1, 6 and 24 h; p < 0.05). Again, in groups 4-5-6, bacterial load was lower for smooth than for textured surfaces at 24 h (p < 0.05). In groups 4-5-6, bacterial load was lower for polyurethane than for smooth surfaces at all time points, but difference was not statistically significant (1, 6 and 24 h; p < 0.05).
The results suggest that local antibiotic therapy was effective in reducing the bacterial load on all surfaces. The effectiveness of local rifamycin on the polyurethane surface was higher, and the duration of activity was longer than other surfaces.
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包膜挛缩是涉及硅胶植入物的乳房手术后最常见的并发症之一。这种情况最可能的原因是生物膜形成。在本研究中，研究了局部抗菌疗法对植入物表面生物膜形成的疗效。
将36只大鼠分为6组。在每只大鼠的背部创建三个腔袋，并将来自光滑、聚氨酯和纹理化植入物的1×2 cm植入物表面样本随机放入腔袋中。所有样本均接种表皮葡萄球菌。在第1 - 2 - 3组中，将接种后的样本分别放入腔袋中，1、6和24小时后取出。在第4 - 5 - 6组中，将浸泡有利福霉素的接种样本分别放入腔袋中，1、6和24小时后取出。用平板计数法测量细菌载量。
第4 - 5 - 6组的细菌载量低于第1 - 2 - 3组（p < 0.05）。在第4 - 5 - 6组中，聚氨酯表面在所有时间点（1、6和24小时）的细菌载量均低于纹理化表面（p < 0.05）。同样，在第4 - 5 - 6组中，光滑表面在24小时时的细菌载量低于纹理化表面（p < 0.05）。在第4 - 5 - 6组中，聚氨酯表面在所有时间点的细菌载量均低于光滑表面，但差异无统计学意义（1、6和24小时；p < 0.05）。
结果表明局部抗生素治疗在降低所有表面的细菌载量方面是有效的。局部利福霉素在聚氨酯表面上的有效性更高，且活性持续时间比其他表面更长。
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