scholarly journals Establishment and Characterization of Bacterial Infection of Breast Implants in a Murine Model

2019 ◽  
Vol 40 (5) ◽  
pp. 516-528 ◽  
Author(s):  
Jennifer N Walker ◽  
Louis H Poppler ◽  
Chloe L Pinkner ◽  
Scott J Hultgren ◽  
Terence M Myckatyn
Keyword(s):  
Staphylococcus Epidermidis ◽  
Breast Implant ◽  
Breast Implants ◽  
Surface Characteristics ◽  
Implant Surface ◽  
Colony Forming Units ◽  
Common Causes ◽  
The Impact ◽  
Post Implantation

Abstract Background Staphylococcus epidermidis and Pseudomonas aeruginosa are the most common causes of Gram-positive and Gram-negative breast implant–associated infection. Little is known about how these bacteria infect breast implants as a function of implant surface characteristics and timing of infection. Objectives The aim of this work was to establish a mouse model for studying the impact of various conditions on breast implant infection. Methods Ninety-one mice were implanted with 273 breast implant shells and infected with S. epidermidis or P. aeruginosa. Smooth, microtextured, and macrotextured breast implant shells were implanted in each mouse. Bacterial inoculation occurred during implantation or 1 day later. Implants were retrieved 1 or 7 days later. Explanted breast implant shells were sonicated, cultured, and colony-forming units determined or analyzed with scanning electron microscopy. Results P. aeruginosa could be detected on all device surfaces at 1- and 7- days post infection (dpi), when mice were implanted and infected concurrently or when they were infected 1- day after implantation. However, P. aeruginosa infection was more robust on implant shells retrieved at 7 dpi and particularly on the macrotextured devices that were infected 1 day post implantation. S. epidermidis was mostly cleared from implants when mice were infected and implanted concurrently. Other the other hand, S. epidermidis could be detected on all device surfaces at 1 dpi and 2 days post implantation. However, S. epidermdis infection was suppressed by 7 dpi and 8 days post implantation. Conclusions S. epidermidis required higher inoculating doses to cause infection and was cleared within 7 days. P. aeruginosa infected at lower inoculating doses, with robust biofilms noted 7 days later.

scholarly journals The A, B and C’s of Silicone Breast Implants: Anaplastic Large Cell Lymphoma, Biofilm and Capsular Contracture

Materials ◽  
2018 ◽  
Vol 11 (12) ◽  
pp. 2393 ◽  
Author(s):  
Maria Mempin ◽  
Honghua Hu ◽  
Durdana Chowdhury ◽  
Anand Deva ◽  
Karen Vickery
Keyword(s):  
Anaplastic Large Cell Lymphoma ◽  
Biofilm Formation ◽  
Cell Lymphoma ◽  
Breast Implant ◽  
Capsular Contracture ◽  
Breast Implants ◽  
Surface Characteristics ◽  
Large Cell ◽  
Breast Implantation ◽  
Large Cell Lymphoma

Breast implantation either for cosmetic or reconstructive e purposes is one of the most common procedures performed in plastic surgery. Biofilm infection is hypothesised to be involved in the development of both capsular contracture and anaplastic large cell lymphoma (ALCL). Capsular contracture is one of the principal reasons for breast revision surgery and is characterised by the tightening and hardening of the capsule surrounding the implant, and ALCL is an indolent lymphoma found only in women with textured implants. We describe the types of breast implants available with regard to their surface characteristics of surface area and roughness and how this might contribute to capsular contracture and/or biofilm formation. The pathogenesis of capsular contracture is thought to be due to biofilm formation on the implant, which results in on-going inflammation. We describe the current research into breast implant associated ALCL and how implant properties may affect its pathogenesis, with ALCL only occurring in women with textured implants.

scholarly journals Biofilm Derived Oxylipin Mediated Autoimmune Response in Breast Implant Subjects

2020 ◽  
Author(s):  
Imran Khan ◽  
Robert E. Minto ◽  
Christine Kelley-Patteson ◽  
Bruce W. Van Natta ◽  
Colby R. Neumann ◽  
...  
Keyword(s):  
Staphylococcus Epidermidis ◽  
Breast Implant ◽  
Breast Implants ◽  
Chronic Fatigue ◽  
Bacterial Biofilm ◽  
Autoimmune Response ◽  
Host Pathogen Interaction ◽  
Number Of Patients ◽  
Biofilm Bacteria ◽  
Insight Into

AbstractOver 10 million women worldwide have breast implants for breast cancer/prophylactic reconstruction or cosmetic augmentation. In recent years, a number of patients have described a constellation of symptoms that are believed to be related to their breast implants. This constellation of symptoms has been named Breast Implant Illness (BII). The symptoms described include chronic fatigue, joint pain, muscle pain and a host of other manifestations often associated with autoimmune illnesses. In this work, we report that bacterial biofilm is associated with BII. We postulate that the pathogenesis of BII is mediated via a host-pathogen interaction whereby the biofilm bacteria Staphylococcus epidermidis interacts with breast lipids to form the oxylipin 10-HOME. The oxylipin 10-HOME was found to activate CD4+ T cells to Th1 subtype. An increased abundance of CD4+Th1 was observed in the breast tissue of BII subjects. The identification of a mechanism of immune activation associated with BII via a biofilm enabled pathway provides insight into the pathogenesis for implant-associated autoimmune symptoms.

scholarly journals The impact of Allergan implant-related issues on patients with breast implants for reconstruction

2021 ◽  
Vol 27 (4) ◽  
pp. 132-138
Author(s):  
Ji Min Kim ◽  
Woo Jin Song ◽  
Hyun Gyo Jeong ◽  
Sang Gue Kang
Keyword(s):  
Case Report ◽  
Breast Implant ◽  
Breast Implants ◽  
Text Messages ◽  
University Hospital ◽  
Prophylactic Surgery ◽  
Outpatient Visits ◽  
First Case ◽  
Significant Difference ◽  
The Impact

Background In August 2019, the Ministry of Food and Drug Safety and the Korean Society of Plastic and Reconstructive Surgeons confirmed the first case report of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) in Korea and provided recommendations. This study was conducted to evaluate the impact of the first case report of BIA-ALCL on patients and whether the impact could be mitigated through expert recommendations.Methods A retrospective chart review was performed of patients who underwent implant-based breast reconstruction using Biocell textured breast implants at Soonchunhyang University Hospital. After the first case report of BIA-ALCL and informing the patients via text messages, the pattern of outpatient visits and the proportion and indications of outpatient office visitors who received reoperations were analyzed.Results After the first BIA-ALCL case report in Korea, 12 patients underwent reoperations due to other complications identified incidentally, while only three patients underwent prophylactic surgery. Among the patients who underwent reoperation after the Allergan issues, 76.7% received implant exchange. There was no significant difference in the proportion of reoperation types before and after the Allergan issues and the transmission of text messages (P=0.700).Conclusions Despite the major issues, outpatients were managed successfully according to our recommendations. The study found a low rate of regular outpatient visits; however, our efforts increased this rate. Therefore, methods for appropriate information delivery are needed for outpatient visits, as well as a system for regular monitoring. As experts, plastic surgeons should provide responsible leadership in this situation to relieve patients’ concerns.

scholarly journals Device-Specific Findings of Imprinted-Texture Breast Implants: Characteristics, Risks, and Benefits

2019 ◽  
Author(s):  
Roger N Wixtrom ◽  
Vikram Garadi ◽  
John Leopold ◽  
John W Canady
Keyword(s):  
Risk Reduction ◽  
Breast Implant ◽  
Capsular Contracture ◽  
Breast Implants ◽  
Surface Metrology ◽  
Textured Surface ◽  
Primary Reconstruction ◽  
Implant Surface ◽  
Risks And Benefits ◽  
Core Study

Abstract Background The relative risks and benefits of various textured breast implants are the focus of considerable discussion. Studies have suggested different risk-benefit profiles for different implant surface topographies. Objectives The study aim was to provide device-specific, quantitative information on Mentor’s imprinted Siltex Textured breast implants with respect to textured surface characteristics and ISO 14607 classification, risk of breast implant–associated anaplastic large cell lymphoma (BIA-ALCL), and risk-reduction benefits relative to smooth implants. Methods Surface metrology was performed. Data for smooth and Siltex implants from the prospective MemoryGel Core Study were evaluated by Kaplan-Meier analysis for the most frequently occurring postoperative complications in augmentation and reconstruction leading to subsequent reoperation. Results The overall average surface roughness for Siltex MemoryGel and MemoryShape implants was 29.5 and 36.1 µm, respectively. A statistically significantly lower rate of reoperation in patients with Siltex compared with smooth devices over 10 years was observed for both capsular contracture in subglandular primary augmentation patients (2.02% vs 19.84%) and for asymmetry in primary reconstruction patients (3.88% vs 11.1%). Conclusions Surface analysis demonstrated that Siltex implants fall within the ISO 14607 category of “microtexture” breast implants. These devices exhibited a rare risk of BIA-ALCL (0.0012%) based on the most extensive data available. Relative to smooth implants, these Siltex devices provided risk-reduction benefits for the most common reason of reoperation in patients who underwent primary augmentation (capsular contracture) or primary reconstruction (asymmetry) in the Core Study. These findings provide valuable risk-benefit information for surgeons and their patients. Level of Evidence: 2

An Assay of Staphylococcus Epidermidis Biofilm Responses to Therapeutic Agents

1993 ◽  
Vol 16 (11) ◽  
pp. 777-787 ◽  
Author(s):  
G.K. Richards ◽  
R.F. Gagnon
Keyword(s):  
Staphylococcus Epidermidis ◽  
Antimicrobial Agents ◽  
Clinical Laboratory ◽  
Relative Rate ◽  
Fluid Phase ◽  
Therapeutic Agents ◽  
Triphenyltetrazolium Chloride ◽  
Implant Surface ◽  
Wide Range ◽  
The Impact

Implant-associated infections tend to become persistent, resisting host defences and antibiotic therapy. Routine clinical laboratory testing of bacterial isolates in the fluid phase for antibiotic susceptibility may not be predictive of therapeutic outcomes and therefore a number of antibiotic regimes have been formulated empirically. The resistance of implant-associated infections has been ascribed to the production by bacteria, when adherent to the implant surface, of a shielding matrix of polymerized carbohydrates protecting the enclosed bacteria from immune defences and antibiotics. This complex of surface, bacteria and matrix is termed a biofilm. We describe a technique to evaluate the efficacy of antimicrobial agents directed against biofilm-forming strains of Staphylococcus epidermidis (a major cause of implant infections) utilizing standardized biofilm preparations formed on glass. The impact of the antimicrobial agents was assessed quantally using the end-point of permanent cessation of metabolic activity (cell death) of the entire biofilm determined by the loss of ability to reduce 2,3,5-triphenyltetrazolium chloride to a visible red intracellular precipitate of formazan. The relative rate of action of differing antimicrobial agents could be determined by the minimum period of exposure of the biofilm to the agents that is required to bring about sterilization, the clinically relevant marker. A wide range of antimicrobial substances could be evaluated, including chemical disinfectants, immunoreactive substances, antibiotics; singly and in combination; and the modifying effects of interaction with non-antibacterial therapeutic agents and other environmental factors. The technique is simple, inexpensive, reproducible and readily adaptable to the clinical situation where evaluation of therapeutic regimes for individual cases of prosthetic device-associated infection is required routinely with despatch and ease of interpretation.

scholarly journals Chronic osteomyelitis as a complication from mycobacteriosis after breast implant

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Márcia Portela Melo ◽  
Luiza Guimaraes de Magdalena ◽  
Marcelo Wainberg Jeffman ◽  
Murilo de Lima Brazan ◽  
Jose Antonio Crespo Cavalheiro
Keyword(s):  
Antibiotic Therapy ◽  
Chronic Osteomyelitis ◽  
Breast Implant ◽  
Breast Implants ◽  
Surgical Instruments ◽  
Augmentation Mammoplasty ◽  
Human Beings ◽  
Bacteriological Test ◽  
The Right ◽  
The Impact

Introduction: Infection is one of the most feared complications in surgeries with the inclusion of breast implants, associated with the need for new procedures and aesthetic compromise. The agents that are most associated with this conditions are the ones that colonize the skin, such as Staphylococcus aureus and Coagulase-negative staphylococci. Case Report: We described the case of a 25-year old patient, who came to our service after an augmentation mammoplasty performed about 60 days before in a hospital in the countryside. She reported bilateral seroma and extrusion of the right breast implant on the 14th postoperative day, being submitted to antibiotic therapy and a new procedure for site review, with the placement of new implants, bilaterally. When she came to our service, on the 45th day after the exchange of implants, she presented with pain, fever, hyperemia and drainage of the purulent secretion in the operative wounds with extrusion of the implants. In the transoperative period, after the changes were identified, on the 3rd, 4th and 5th costal arches to the right, suggestive of osteomyelitis, associated with partial necrosis of the intercostal muscles and pectoralis minor. The bacteriological test of the periprosthetic secretion was bilaterally positive for mycobacteruim abscessus, and the anatomopathological study of the right costal arch biopsy was compatible with chronic osteomyelitis. The patient presented favorable clinical evolution after the removal of the implants and antibiotic therapy. Discussion: Mycobacteria are opportunistic organisms, which hardly cause diseases in human beings. Despite being uncommon, the infection of breast implants by mycobacteria can be associated with the contamination of surgical instruments and immunosuppression of the host. The infection can be similar to those caused by more common agents. In many cases, it presents with the later onset of symptoms. Prophylaxis and antisepsis, including special care regarding the protocols of sterilization of surgical instruments, are still the main factors associated with the impact of this type of complication in surgeries with breast implants.

scholarly journals Physical and Structural Characterization of Underutilized Climate-Resilient Seed Grains: Millets, Sorghum, and Amaranth

2021 ◽  
Vol 5 ◽  
Author(s):  
Sarah Geisen ◽  
Kiruba Krishnaswamy ◽  
Rob Myers
Keyword(s):  
Food Processing ◽  
Surface Characteristics ◽  
Angle Of Repose ◽  
Healthy Foods ◽  
Underutilized Crops ◽  
Sem Images ◽  
Processing Technologies ◽  
Loss And Damage ◽  
The Impact

While the world is facing food and nutritional challenges leading to the multifaceted burden of malnutrition (underweight and overweight), there is a need to sustainably diversify and explore underutilized crops. Climate-resilient crops, which have the potential to withstand climate crises, have drought resistance, and provide healthy foods with essential vitamins and minerals. Ancient seed grains like amaranth, millets, and sorghum are highly nutritious seed grains that are underutilized, and there is a need for comprehensive research into their properties. This study will specifically investigate amaranth alongside barnyard, finger, kodo, little, pearl, proso millets, and sorghum. Physical and structural properties of the ancient seed grains can provide useful data for storage and food processing. The angle of repose, porosity, and water activity of the grains varied from 19.3° to 23.9°, 3.6 to 17.4%, and 0.533 to 0.660 at 25.5°C, respectively. Additionally, Scanning Electron Microscopy (SEM) was used to observe the surface characteristics and overall shape of each grain. SEM images of the millets shows the impact of dehulling on the surface morphology of the grains (little, barnyard, proso, and kodo millets). This calls for research and development of novel food processing technologies to minimize loss and damage during processing of climate-resilient crops.

scholarly journals Influence of Breast Implant Surface Finishing on Physicochemical and Mechanical Properties before and after Extreme Degradation Studies

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Izabelle de Mello Gindri ◽  
Lucas Kuth de Azambuja ◽  
Michele da Silva Barreto ◽  
Dionatha José do Prado ◽  
Gean Vitor Salmoria ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Breast Implant ◽  
Breast Implants ◽  
Surface Finishing ◽  
Implant Surface ◽  
Local Erosion ◽  
Before And After ◽  
Acidic Conditions ◽  
Degradation Studies ◽  
Weight Structures

The influence of the surface finishing of breast implants on physicochemical and mechanical properties, before and after extreme degradation experiments, was investigated in this study. Removal of superficial layers after degradation was verified for both smooth and rough membranes, in which local erosion was verified. FTIR results demonstrated the generation of low-molecular-weight structures in all samples due to exposure to acidic and basic environments. Furthermore, smooth samples presented higher degrees of crosslinking than rough samples. Considering the mechanical properties, no difference was verified between smooth and rough samples as received and after degradation studies. However, the pH of the degradation solution had an influence on mechanical properties of the material and a basic environment caused greater deterioration of the mechanical properties compared to acidic conditions.

scholarly journals Particulate Debris Released From Breast Implant Surfaces Are Highly Dependent on Implant Type

2021 ◽  
Author(s):  
Nadim James Hallab ◽  
Lauryn Samelko ◽  
Dennis Hammond
Keyword(s):  
Total Mass ◽  
Ex Vivo ◽  
Breast Implant ◽  
Breast Implants ◽  
Particulate Material ◽  
Tissue Analysis ◽  
Implant Surface ◽  
Different Types ◽  
Particulate Debris

Abstract Background While Breast Implants (BIs) have never been safer, factors such as implant debris may influence complications such as chronic inflammation and illness such as ALCL. Do different types of BIs produce differential particulate debris? Objectives Our objective was to quantify, investigate and characterize the size, amount, and material-type of both loosely bound and adherent surface particles, using five different surface types of commercial BIs. Methods Surface particles from 5 surface types of BIs (n=5/group); Biocell, Microcell, Siltex, Smooth, SmoothSilk, and Traditional-Smooth were: 1) removed by a rinsing procedure and 2) removed using ultrapure-adhesive carbon-tabs. Particles were characterized (ASTM 1877-16) using Scanning-Electron-Microscopy and EDX-chemical analysis. Results Particles rinsed from Biocell, Microcell and Siltex were <1 micron in diameter while SmoothSilk and Traditional-Smooth surfaces had median sizes >1micron (range: 0.4-2.7microns). The total mass of particles rinsed from the surfaces indicated Biocell had >5 fold-more particulate compared to all other implants, and >30 fold-more than SmoothSilk or Traditional-Smooth implants (>100x more for post rinse adhesion analysis). EDX analysis indicated particulate material for Biocell, Microcell and Siltex was silicone (>50%), while particulate from SmoothSilk and Traditional-Smooth implants were predominantly carbon-based polymers, eg, polycarbonate-urethane, consistent with packaging (and were detected on all implant types). Generally, SmoothSilk and Traditional-Smooth implant groups had >10x fewer particles released than Biocell, Microcell and Siltex surfaces. Pilot ex-vivo tissue analysis supported these findings. Conclusions Particulate debris released from BIs are highly dependent on the type of implant surface and is a likely key determinant of in vivo performance.

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