Optimizing Breast Pocket Irrigation: The Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) Era.

Abstract

BACKGROUND:

Specific antimicrobial breast pocket irrigations have been proven over the past 20 years to reduce the incidence of capsular contracture by a factor of 10, and the emergence of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) and its link to bacteria/technique has created renewed interest in different antimicrobial breast pocket preparation agents. Our previous studies have identified that both Betadine-containing and non-Betadine-containing antimicrobial irrigations provide excellent broad-spectrum bacterial coverage. The current science of BIA-ALCL has implicated the Gram-negative microbiome as a key in pathogenesis.

OBJECTIVES:

The aim of this study was to revisit the antimicrobial effectiveness of clinically utilized Betadine and non-Betadine solutions, along with other antimicrobial agents that have not yet been tested, against multiple organisms, including additional common Gram-negative bacteria associated with chronic breast implant infections/inflammation.

METHODS:

Current and new antimicrobial breast irrigations were tested via standard techniques for bactericidal activity against multiple Gram-positive and Gram-negative strains. Test results are detailed and clinical recommendations for current antimicrobial irrigations are provided.

RESULTS:

Betadine-containing irrigations were found to be superior according to the testing performed.

CONCLUSIONS:

There are quite few misconceptions with regard to antimicrobial breast pocket irrigation. These are discussed and final evidence-based recommendations for practice are given.

• Authors: Eric J Culbertson, Christina Felder-Scott, Anand K Deva, David E Greenberg, William P Adams
• Journal: Aesthetic surgery journal (Aesthet Surg J) Vol. 40 Issue 6 Pg. 619-625 (05 16 2020) ISSN: 1527-330X [Electronic] England
• PMID: 31501857 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2019 The Aesthetic Society. Reprints and permission: [email protected].

Topics

• Breast
• Breast Implantation (adverse effects)
• Breast Implants (adverse effects)
• Breast Neoplasms (etiology, surgery)
• Humans
• Lymphoma, Large-Cell, Anaplastic (epidemiology, etiology)