Silicon breast implants’ texture affecting bacterial biofilm formation

Abstract

Introduction/Objective. The most important etiologic factors for both, capsular contracture (CC) and breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is subclinical infection, defined as a response of an organism on presence of biofilm on the implant surface. The aim of this research was to examine the possibility of biofilm formation of four different bacteria (Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, and Ralstonia picketti) on three differently textured silicone breast implants (Siltex, Mentor, pore size 70–150 μm; MESMORsensitive, Polytech, pore size 50–900 μm; and SilkSurface, Motiva pores 13 μm) in vitro. Methods. Samples of silicone breast implant capsules (sized 1 × 1 cm) were divided into three groups according to texture. After sterilization, 30 samples in every group were contaminated with 100 μl of examined bacterial broth, followed by incubation which led to biofilm formation. For testing the capability of biofilm formation, modified technique with microtitar plates described by Stepanović was used. Results. All four examined bacteria (Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, and Ralstonia picketti) form more biofilm on implants with pore sizes 50–900 μm compared to implants with pore size 70–150 μm and those with 13 μm. Statistical significance was found in biofilm formation on implants with pores 70–150 μm compared to implants with pores 13 μm. The only exception was P. aeuruginosa which did not show significant difference in biofilm formation on implants 70–150 μm and 13 μm. Conclusion. Silicone breast implants with micro and nanotexture should be chosen in order to prevent biofilm formation and possible consequent complications.

Keywords

• biofilm
• bacterial adhesion
• prosthesis-related infections
• breast implants
• silicon elastomers