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Microbial evaluation: 139 implants removed from symptomatic patients

C Y Ahn1, C Y Ko, E A Wagar

  • 1Division of Plastic and Reconstructive Surgery, UCLA School of Medicine, USA.

Plastic and Reconstructive Surgery
|December 1, 1996
PubMed
Summary
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Microbial colonization, particularly Propionibacterium acnes and Staphylococcus epidermidis, is frequent in symptomatic silicone implants. This colonization was not significantly linked to implant rupture or patient symptoms.

Area of Science:

  • Microbiology
  • Biomaterials Science
  • Plastic Surgery

Background:

  • Microbial organisms are suspected in adverse effects for symptomatic silicone implant patients.
  • Previous studies identified various bacteria like Staphylococcus aureus and Clostridium perfringens in implant-related issues.
  • Infections in polyurethane-coated prostheses can increase patient morbidity.

Purpose of the Study:

  • To determine the frequency, type, and clinical relevance of microbial colonization on explanted silicone implants from symptomatic patients.
  • To investigate the impact of microbial colonization on implant integrity, including gel bleed and rupture.

Main Methods:

  • A prospective study analyzed 139 implants from 72 symptomatic patients (February 1993 - July 1994) at UCLA Medical Center.

Related Experiment Videos

  • Implants included various shell types (smooth, polyurethane, textured) and locations (subglandular, submuscular).
  • Cultures were performed on explanted implant surfaces; implant integrity (intact vs. ruptured) was assessed.
  • Main Results:

    • Of 139 implants, 31% were ruptured. 47% of implants were culture-positive.
    • Propionibacterium acnes (57.5%) and Staphylococcus epidermidis (41%) were the most common isolates; no fungal infections were found.
    • Culture positivity did not correlate significantly with systemic symptoms. 33% of culture-positive implants were ruptured.

    Conclusions:

    • Microbial colonization is common in symptomatic silicone implants, with P. acnes and S. epidermidis being predominant.
    • The study identified the frequency and types of microbial colonization in this patient group.
    • Further research may clarify the precise role of these microbes in implant-related symptoms and complications.