Povidone-Iodine versus antibiotic irrigation in breast implant surgery: Revival of the ideal solution

Dang, Tru; Yim, Nicholas H.; Tummala, Sailesh V.; Parsa, Alan A.; Parsa, Fereydoun Don

doi:10.1016/j.bjps.2019.09.007

Cited by 13 publications

(9 citation statements)

References 5 publications

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“…Given the fact that hitherto the exact cause for capsular contraction has not yet been determined sufficiently, the biofilm hypothesis is one of the major corner stones to explain fibroblast proliferation. Chronic inflammation is somehow considered to play a role in this entity and hence numerous authors have tried to circumvent biofilm occurrence utilizing various disinfectants or antibiotic solutions, applied directly to implants, and into the implant pockets ( Dang et al, 2020 ; Jewell et al, 2021 ; Nai et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

“…Several therapeutic measures have been proposed to reduce the bacterial load of implants during surgery, such as washing the breast pocket with antiseptic solutions, being the most common a triple antibiotic dilution (Cefazolin 1 g, Bacitracin 50,000 U, Gentamicin 80 mg) followed by povidone iodine (PI) ( Chopra et al, 2017 ; Drinane et al, 2017 ; Banerjee and Featherstone, 2019 ; Carvajal et al, 2019 ). Another alternative is to irrigate or immerse the implant before its placement; but to date there is no agreement on the optimal product to use ( Ta et al, 2008 ; Dang et al, 2020 ). Despite this lack of consensus, a recent study by Ngaage et al (2020) has shown that PI is the most effective irrigating formula in reducing contamination of smooth breast implants by methicillin-resistant S. aureus and S. epidermidis , shown in a 30-min in vitro test.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of Povidone Iodine Against Microbial Biofilms in Breast Implants With Different Textures: Results From an in vitro Study

et al. 2022

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BackgroundIn the practice of breast augmentation and reconstruction, implant irrigation with various solutions has been widely used to prevent infection and capsular contracture, but to date, there is no consensus on the optimal protocol to use. Recently, application of povidone iodine (PI) for 30 min has shown in vitro to be the most effective irrigating formula in reducing contamination in smooth breast implants. However, as 30 min is not feasible intraoperatively, it is necessary to determine whether shorter times could be equally effective as well as to test it in both smooth and textured implants.MethodsWe tested the efficacy of 10% PI at 1′, 3′, and 5′ against biofilms of 8 strains (2 ATCC and 6 clinical) of Staphylococcus spp. on silicone disks obtained from Mentor® and Polytech® implants of different textures. We analyzed the percentage reduction of cfu counts, cell viability and bacterial density between treatment (PI) and control (sterile saline, SS) groups for each time of application. We consider clinical significance when > 25% reduction was observed in cell viability or bacterial density.ResultsAll textured implants treated with PI at any of the 3 exposure times reduced 100% bacterial load by culture. However, none of the implants reached enough clinical significance in percentage reduction of living cells. Regarding bacterial density, only 25–50 μm Polytxt® Polytech® implants showed significant reduction at the three PI exposure times.ConclusionPI is able to inhibit bacterial growth applied on the surface of breast implants regardless of the exposure time. However, no significant reduction on living cells or bacterial density was observed. This lack of correlation may be caused by differences in texture that directly affect PI absorption.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy of Povidone Iodine Against Microbial Biofilms in Breast Implants With Different Textures: Results From an in vitro Study

et al. 2022

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“…Many studies endorse the use of povidone-iodine pocket irrigation for its widespread antimicrobial activity, low cost and efficacy in dissolving biofilms [ 30 , 78 , 79 , 80 , 81 ]. Furthermore, Betadine may be preferable to other antibiotic irrigation solutions because of its low immunogenicity and no documented evidence of bacterial resistance [ 78 , 82 ]. There is no standardized formulation of Betadine used as an irrigation solution.…”

Section: Implications For Clinical Practicementioning

confidence: 99%

The Role of Microorganisms in the Development of Breast Implant-Associated Anaplastic Large Cell Lymphoma

et al. 2023

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Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a variant of anaplastic large cell lymphoma (ALCL) associated with textured-surface silicone breast implants. Since first being described in 1997, over 1100 cases have been currently reported worldwide. A causal relationship between BIA-ALCL and textured implants has been established in epidemiological studies, but a multifactorial process is likely to be involved in the pathogenesis of BIA-ALCL. However, pathophysiologic mechanisms remain unclear. One of the hypotheses that could explain the link between textured implants and BIA-ALCL consists in the greater tendency of bacterial biofilm in colonizing the surface of textured implants compared to smooth implants, and the resulting chronic inflammation which, in predisposed individuals, may lead to tumorigenesis. This review summarizes the existing evidence on the role of micro-organisms and rough surface implants in the development of BIA-ALCL. It also provides insights into the most updated clinical practice knowledge about BIA-ALCL, from clinical presentation and investigation to treatment and outcomes.

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“…17 PVP-I is also an attractive choice owing to its excellent anti-corrosion properties, safety, lack of resistance, accessibility and low cost. 18 Under these circumstances, in the face of the current severe pandemic, this current evaluated the inhibitive effect of PVP-I on SARS-CoV-2 in a Vero cell model. This current study provides theoretical guidelines and data support for the use of disinfectants in oral clinical environments during the COVID-19 pandemic.…”

Section: Introductionmentioning

confidence: 99%

Virucidal effect of povidone-iodine against SARS-CoV-2 in vitro

Wang

et al. 2021

J Int Med Res

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Objective To evaluate the antiviral activity of the oral disinfectant povidone-iodine (PVP-I) against severe acute respiratory syndrome-coronavirus-2 (SARS-CoV2) in vitro. Methods The cytotoxic effects of PVP-I were determined in Vero and Calu-3 cell lines using that by Cell Counting Kit-8 assay. Viral load in the cell culture medium above infected cells was quantitated using real-time polymerase chain reaction. The cytopathic effect (CPE) and viral infective rate were observed by immunofluorescence microscopy. Results PVP-I at a concentration >0.5 mg/ml in contact with SARS-CoV-2 for 30 s, 1 min, 2 min and 5 min showed up to 99% viral inhibition. For in vitro testing, upon exposure for 1 min, PVP-I showed a virucidal effect. PVP-I had no cytotoxic effects at the range of concentrations tested (0.125–1 mg/ml; CC50 > 2.75 mM) in Vero and Calu-3 cells. Conclusion These results demonstrate that the ideal contact time was 1 min and the optimal concentration was 1 mg/ml, which provides an experimental basis for the use of oral disinfectants in dental hospitals.

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Povidone-Iodine versus antibiotic irrigation in breast implant surgery: Revival of the ideal solution

Cited by 13 publications

References 5 publications

Efficacy of Povidone Iodine Against Microbial Biofilms in Breast Implants With Different Textures: Results From an in vitro Study

Efficacy of Povidone Iodine Against Microbial Biofilms in Breast Implants With Different Textures: Results From an in vitro Study

The Role of Microorganisms in the Development of Breast Implant-Associated Anaplastic Large Cell Lymphoma

Virucidal effect of povidone-iodine against SARS-CoV-2 in vitro

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