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Journal of Long-Term Effects of Medical Implants

ISSN Print: 1050-6934
ISSN Online: 1940-4379

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.2016016851
pages 237-243

Presence of Biofilms on Polyurethane-Coated Breast Implants: Preliminary Results

Ulrich M. Rieger
Department of Plastic & Aesthetic, Reconstructive & Hand Surgery, AGAPLESION Markus Hospital, Johann Wolfgang von Goethe University, Frankfurt am Main, Germany; Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria
Gabriel Djedovic
Department of Plastic & Aesthetic, Reconstructive & Hand Surgery, St. Markus Hospital, Johann Wolfgang von Goethe University, Germany; Department of Plastic, Reconstructive & Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria
Alexander Pattiss
Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria
Gregor F. Raschke
Department of Cranio-Maxillofacial Surgery & Plastic Surgery, Friedrich Schiller University Jena, Erlanger Allee 101, 07747 Jena, Germany
Reno Frei
Clinical Microbiology, Laboratory Medicine, University Hospital, Basel, Switzerland
Gerhard Pierer
Department of Plastic, Reconstructive & Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria; Clinical Microbiology, Laboratory Medicine, University Hospital, Basel, Switzerland
Andrej Trampuz
Center for Septic Surgery and Infectious Diseases, Center for Musculoskeletal Surgery, Charite-University Medicine Berlin, Berlin, Germany

ABSTRACT

Polyurethane-coated breast implants seem to be associated with lower medium- and long-term capsular contracture rates in comparison to textured or smooth implant surfaces. Although the etiology of capsular contracture is uncertain, bacterial biofilms have been suggested to trigger chronic peri-implant inflammation, eventually leading to capsular contracture. It is unknown whether polyurethane-coated implants are less prone to biofilm colonization than other implant surfaces.
We extracted data from patient records included in a prospective cohort between 2008 and 2011. All patients who underwent removal of polyurethane-coated implants were included in this current study and screened for presence of biofilms by sonication. In addition, implant- and patient-related data were analyzed.
Of the ten included polyurethane-coated breast implants, six had been inserted for reconstructive purposes and four for aesthetic reasons. The median implant indwelling time was 28.3 mo. Overall, sonication cultures were positive in 50% of implants. Propionibacterium acnes and coagulase-negative staphylococci were the predominant pathogens isolated from biofilm cultures. Like other implant surfaces, polyurethane-coated implants are prone to biofilm colonization. Further investigations are needed to determine why capsular contracture rates seem to be lower in polyurethane implants than in other implant surfaces. Notably, in this study, 40% of the implants were explanted from breasts with severe capsular contracture.