I get these blogs are not sexy and fun to read, but avoiding contamination of breast implants is super important. We know biofilm, a low grade infection established early in implants, leads to capsular contracture, chronic inflammation, and breast implant illness.
This was in the June 2024 issue of Aesthetic Surgery Journal, “Preventing Bacterial Contamination of Breast Implants Using Infection Mitigation Techniques: An In Vitro Study.” The study talks about the importance of bacterial infection prevention. This was a study in the lab.
Study:
- Looked at Smooth vs. Textured implants to see if bacterial loads higher.
- Barrier techniques to protect the implant when placing it inside the body:
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- Sterile glove insertion technique
- Opsite/barrier
- Reprep with betadine 10% and allowed to dry
- Keller funnel loaded with sterile saline
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- Each of these measures was assessed with 5 implant passes. Then the bacterial colonies were counted and analyzed.
Findings?
- Smooth implants and textured implants were about the same for bacterial counts.
- Implant placement bacterial levels:
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- Opsite 18
- Keller 4
- Betadine 16
- glove insertion technique 108
- control 594
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Conclusion?
All of the mitigation techniques produced a statistically significant quantitative reduction in the number of bacterial colonies. They talk about how many plastic surgeons still do not utilize some technique to lower the number of bacteria. The numbers have improved in the past decade, but why isn’t everyone doing something? They do allude to the cost (Each Keller funnel is $150+, but I feel worth it) and maybe lack of education of the surgeons.
They cited a bunch of Keller funnel studies which all showed significant lowering of bacterial counts: lower rates of capsular contracture at 12 months, 87% reduction in capsular contracture, this study shows 148x reduction in bacterial counts.
They also talked about sizing implants (used during the surgery to figure out what implants to open for your final implants) and how using those can contaminate the implant pocket prior to placing your final implant. I believe in that as well, and I use antibiotic irrigations like mad on the skin and in the pocket and on my instruments when placing implants. And I love the Keller funnel.
My thoughts?
Speaking to the choir. I was impressed by the numbers and it reinforces my dedication to the Keller funnel and my techniques. It makes a difference. Prevention of biofilm is key to avoiding capsular contracture, chronic inflammation, and breast implant illness.