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隆胸手术中确保两侧植入条件相同:对植入漏斗进行有效消毒

Ensuring Equal Implantation Conditions on Both Sides During Breast Augmentation: Effective Decontamination of Implantation Funnels.

作者信息

Montemurro Paolo, Gupta Tarush

机构信息

Akademikliniken, Stockholm, Sweden.

Department of Plastic Surgery, Post Graduate Institute of Medical Education and Research (PGIMER), D-47, F-Block, 2nd floor, Nehru Hospital, Chandigarh, 160047, India.

出版信息

Aesthetic Plast Surg. 2025 Jun 2. doi: 10.1007/s00266-025-04962-1.


DOI:10.1007/s00266-025-04962-1
PMID:40456997
Abstract

BACKGROUND: The role of mitigation strategies to decrease contamination during breast implant surgery has advanced over the years, and the utility of implantation funnels has been recently validated by several studies. However, the additional cost of using separate funnels for each breast has led surgeons to use the same funnel on both sides, which increases the risk of microbial contamination and complications such as capsular contracture in the second breast. METHODS: This prospective study included ten consecutive patients undergoing primary breast augmentation. The sterility of the funnels was initially confirmed by microbiological analysis of samples taken from the tip of the funnel immediately after opening. After implantation in the right breast, a second sample set was taken from the funnel. The funnel was then decontaminated using a 2% chlorhexidine with 70% isopropyl alcohol solution, air-dried, and a third sample from the tip was taken. The decontaminated funnel was then used for the left breast implantation. These three samples were analyzed for microbial contamination. RESULTS: Initial funnel samples were found to be sterile, meeting the manufacturer's sterility standards. However, after the initial use, all samples were contaminated with microorganisms (Staphylococcus epidermidis in seven cases and Cutibacterium acnes in three cases). Following chlorhexidine treatment, all samples were found sterile, demonstrating the effectiveness of the decontamination process. CONCLUSION: Reusing a single funnel for both breast implants increases the risk of microbial contamination in the second breast. However, treating the funnel with a chlorhexidine-isopropyl alcohol solution effectively restores sterility, reducing contamination risks and maintaining cost-effectiveness. This decontamination process offers a viable and cost-effective solution for enhancing patient safety and reducing complications in breast implant surgery. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

摘要

背景:多年来,减少乳房植入手术中污染的缓解策略的作用不断发展,植入漏斗的效用最近已得到多项研究的验证。然而,为每个乳房使用单独的漏斗所产生的额外成本导致外科医生在两侧使用同一个漏斗,这增加了微生物污染的风险以及第二个乳房出现包膜挛缩等并发症的风险。 方法:这项前瞻性研究纳入了连续10例接受初次隆乳手术的患者。漏斗的无菌性最初通过在打开后立即从漏斗尖端采集的样本进行微生物分析来确认。在右乳植入后,从漏斗中采集第二组样本。然后使用含2%氯己定和70%异丙醇的溶液对漏斗进行消毒,风干后,从尖端采集第三个样本。然后将消毒后的漏斗用于左乳植入。对这三个样本进行微生物污染分析。 结果:最初的漏斗样本被发现是无菌的,符合制造商的无菌标准。然而,在初次使用后,所有样本都被微生物污染(7例为表皮葡萄球菌,3例为痤疮丙酸杆菌)。经过氯己定处理后,所有样本均被发现无菌,证明了消毒过程的有效性。 结论:两个乳房植入使用同一个漏斗会增加第二个乳房微生物污染的风险。然而,用氯己定-异丙醇溶液处理漏斗可有效恢复无菌状态,降低污染风险并保持成本效益。这种消毒过程为提高乳房植入手术中的患者安全性和减少并发症提供了一种可行且具有成本效益的解决方案。 证据级别IV:本刊要求作者为每篇文章指定一个证据级别。有关这些循证医学评级的完整描述,请参阅目录或在线作者指南www.springer.com/00266 。

相似文献

[1]
Ensuring Equal Implantation Conditions on Both Sides During Breast Augmentation: Effective Decontamination of Implantation Funnels.

Aesthetic Plast Surg. 2025-6-2

[2]
Devil's Advocate: Evidence-Based Recommendation for "One Breast-One Insertion Funnel" Policy.

Aesthet Surg J. 2024-1-16

[3]
Is Salvage of Recently Infected Breast Implant After Breast Augmentation or Reconstruction Possible? An Experimental Study.

Aesthetic Plast Surg. 2018-4

[4]
Proper Skin Management in Breast Augmentation with a Periareolar Incision Prevents Implant Contamination and Biofilm-Related Capsular Contracture.

Aesthetic Plast Surg. 2021-8

[5]
Capsular Contracture After Breast Augmentation: Our Approach to Prevent Reoccurrence with Combined Total Capsulectomy and Implantation of Motiva Ergonomix® Implants.

Aesthetic Plast Surg. 2025-4

[6]
Implant Insertion Time and Incision Length in Breast Augmentation Surgery with the Keller Funnel: Results from a Comparative Study.

Aesthetic Plast Surg. 2019-8

[7]
Higher Prevalence of Capsular Contracture with Second-side Use of Breast Implant Insertion Funnels.

Plast Reconstr Surg Glob Open. 2021-11-2

[8]
Silicone Breast Implant Injector: A Retooled Breast Augmentation Device.

Aesthetic Plast Surg. 2021-2

[9]
A Histological Assessment Tool for Breast Implant Capsules Validated in 480 Patients with and Without Capsular Contracture.

Aesthetic Plast Surg. 2025-1

[10]
Breast Augmentation Surgery: How Do We Do It? Results of a Joint Survey from European Association of Societies of Aesthetic Plastic Surgery.

Aesthetic Plast Surg. 2020-12

本文引用的文献

[1]
Devil's Advocate: Evidence-Based Recommendation for "One Breast-One Insertion Funnel" Policy.

Aesthet Surg J. 2024-1-16

[2]
The Keller Funnel, Capsular Contracture, and Conflict of Interest: A Review.

Ann Plast Surg. 2023-8-1

[3]
Keller Funnel Efficacy in "No Touch" Breast Augmentation and Reconstruction: A Systematic Review.

Plast Reconstr Surg Glob Open. 2022-11-23

[4]
Optimizing Breast Pocket Irrigation: The Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) Era.

Aesthet Surg J. 2020-5-16

[5]
Risk Factor Analysis for Capsular Contracture: A 10-Year Sientra Study Using Round, Smooth, and Textured Implants for Breast Augmentation.

Plast Reconstr Surg. 2018-4

[6]
Betadine and Breast Implants.

Aesthet Surg J. 2018-5-15

[7]
The Relationship of Bacterial Biofilms and Capsular Contracture in Breast Implants.

Aesthet Surg J. 2016-3

[8]
Understanding the Etiology and Prevention of Capsular Contracture: Translating Science into Practice.

Clin Plast Surg. 2015-10

[9]
Risk of breast implant bacterial contamination from endogenous breast flora, prevention with nipple shields, and implications for biofilm formation.

Aesthet Surg J. 2012-9-10

[10]
Systematic review and meta-analysis of preoperative antisepsis with chlorhexidine versus povidone-iodine in clean-contaminated surgery.

Br J Surg. 2010-11

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