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Saturday, September 29, 2018: 9:00 AM
Background:
Capsular contracture is an important complication after breast surgery involving implants. The etiology of capsular contracture is multifactorial and remains unclear. Recent evidence suggests that bacterial biofilm on the implant surface may be a determinant factor in developing capsular contracture. On the other side, texturization of the surface of implants has been a major improvement in reducing capsular contracture. In this scenario, the authors decided to investigate, in vitro, the relationship between biofilm formation and surfaces of the implants by analyzing the rate of bacterial growth and adhesion to different implant surfaces.
Methods:
Multiple 1.5 cm2 samples of four differently surfaced implants (smooth, micro-textured and two macro-textured implants from different manufacturers) were inoculated with 6 different human strains of Staphylococcus epidermidis isolated on infected breast implants explanted in our Plastic Surgery Unit. The bacterial cultures were grown at 37 °C in TSB culture media. The samples underwent both quantitative bacterial analysis (O.D. 600nm) and imaging using scanning electron microscopy. Paired Student’s T-test was used to calculate whether the number of bacteria attached among the different implant surfaces were statistically significant. A two-tailed p value of < 0.05 was considered significant.
Results:
Our analysis showed that the difference in number of bacteria attached to the macro-textured samples compared with micro-textured was statistically significant (p < 0.05). On the other hand, the difference between micro-textured and smooth implants was not statistically significant (p > 0.05). These findings were confirmed by imaging analysis. Scanning electron microscopy showed denser biofilm on the surface of macro-textured implants compared with micro-textured and smooth implants. In addition, there was a difference among the different bacteria strains analyzed. One strain demonstrated high capability of forming biofilm both on macro-textured, micro-textured and smooth implants with no significant difference between the different surfaces.
Conclusions:
These results suggest that macro-textured implants may be more prone to host biofilm forming bacteria in comparison with micro-textured and smooth implants. From our findings micro-textured implants behave similarly to smooth implants. The limit of our study is that it was conducted only in vitro. Moreover, we found that certain strains manifested high capability of adherence on every surface analyzed. Further in vivo studies are necessary to clarify the clinical implication of our experimental results, both in preventing implant infection and capsular contracture.
Capsular contracture is an important complication after breast surgery involving implants. The etiology of capsular contracture is multifactorial and remains unclear. Recent evidence suggests that bacterial biofilm on the implant surface may be a determinant factor in developing capsular contracture. On the other side, texturization of the surface of implants has been a major improvement in reducing capsular contracture. In this scenario, the authors decided to investigate, in vitro, the relationship between biofilm formation and surfaces of the implants by analyzing the rate of bacterial growth and adhesion to different implant surfaces.
Methods:
Multiple 1.5 cm2 samples of four differently surfaced implants (smooth, micro-textured and two macro-textured implants from different manufacturers) were inoculated with 6 different human strains of Staphylococcus epidermidis isolated on infected breast implants explanted in our Plastic Surgery Unit. The bacterial cultures were grown at 37 °C in TSB culture media. The samples underwent both quantitative bacterial analysis (O.D. 600nm) and imaging using scanning electron microscopy. Paired Student’s T-test was used to calculate whether the number of bacteria attached among the different implant surfaces were statistically significant. A two-tailed p value of < 0.05 was considered significant.
Results:
Our analysis showed that the difference in number of bacteria attached to the macro-textured samples compared with micro-textured was statistically significant (p < 0.05). On the other hand, the difference between micro-textured and smooth implants was not statistically significant (p > 0.05). These findings were confirmed by imaging analysis. Scanning electron microscopy showed denser biofilm on the surface of macro-textured implants compared with micro-textured and smooth implants. In addition, there was a difference among the different bacteria strains analyzed. One strain demonstrated high capability of forming biofilm both on macro-textured, micro-textured and smooth implants with no significant difference between the different surfaces.
Conclusions:
These results suggest that macro-textured implants may be more prone to host biofilm forming bacteria in comparison with micro-textured and smooth implants. From our findings micro-textured implants behave similarly to smooth implants. The limit of our study is that it was conducted only in vitro. Moreover, we found that certain strains manifested high capability of adherence on every surface analyzed. Further in vivo studies are necessary to clarify the clinical implication of our experimental results, both in preventing implant infection and capsular contracture.