Examining the Role of Antimicrobial Irrigation and Capsular Contracture

Abstract

Antimicrobial irrigation of implant pockets fails to reduce the propensity for CC. The authors recommend that further prospective multicenter trials be conducted to further elucidate the role of antibiotic irrigation in CC.

Revision Breast Augmentation

“…In fact, recent systematic reviews and meta-analysis offer conflicting conclusions on the efficacy of the use antimicrobial irrigation for prevention of capsular contracture. 34,35 However, a recent survey of ASPS members found 41.2% of plastic surgeons used triple antibiotic solution, 16.5% used triple antibiotic with Betadine, less than 10% used dilute Betadine, and only 4.1% used normal saline without antibiotic irrigation. 36 The "no-touch technique"-which involves some variation of placing new gloves, using a sleeve/funnel for insertion, and minimal manipulation once inserted-is thought to decrease contamination of the implant by the surgeon's gloves and the patient's skin flora, and avoid contamination of the implant once in situ.…”

A Rebuttal of the 12 Breast Reconstruction Points to Minimize Implant Contamination

“…Recent systematic reviews fail to show a clear benefit for triple antibiotic or betadine irrigation (point 8). 6–8 In fact, triple antibiotic pocket irrigation may be counterproductive. 8,9 Betadine may be nonsterile 10 and should not be used to irrigate surgical wounds.…”

Does Antibiotic Irrigation Really Reduce the Risk of Capsular Contracture of the Breast?

“…These guidelines recommend against its use [ 19 ]. Fibrinogenic and proinflammatory antimicrobials that are used for pocket irrigation have been linked to an increased incidence of capsular contracture [ 20 ]. Some investigators dispute such deleterious effects and point to the absence of a definitive study in the context of a breast implant [ 18 ].…”