Montemurro Paolo, Gupta Tarush
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.
Aesthetic Plast Surg. 2025 Jun 2. doi: 10.1007/s00266-025-04962-1.
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.
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.
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.
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.
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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。
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。
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。
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。
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