Fungal Contamination in Breast Implant Surgery: A Rare, Preventable Complication
Although apparently uncommon, fungal contamination of saline-filled breast implants is readily preventable, according to a study in the July 1 issue of The Journal of Infectious Diseases, now available online. The key steps are to use closed systems for filling the devices and to adhere to the strict moisture control and operating room ventilation standards in force at major hospitals. The potential benefits of these precautions could be considerable, since 265,832 women in the United States underwent cosmetic or reconstructive breast surgery in 2000 alone, and most received saline-filled implants. Moreover, increasing numbers of non-surgeons are performing cosmetic breast surgery in outpatient clinics, ambulatory surgery centers, or physician offices, where the risk of complications is especially likely without precautions. This study is a case in point.
The investigators, Marion A. Kainer, MBBS, MPH, and coworkers at the Centers for Disease Control and Prevention studied an outbreak in 2000-2001 that involved five women whose implants were found to contain black sediment during revision surgery for cosmetic breast augmentation; the sediment was subsequently identified as Curvularia, a fungus commonly found in soil. All women had been treated in 2000 at an ambulatory surgical facility, where an initial in-house investigation failed to find a source of contamination.
Dr. Kainer and colleagues conducted an extensive investigation to identify factors contributing to the outbreak. They found that sterile saline used to fill the implants was stored directly under a portion of ceiling sheetrock that had been water-damaged a few years before and was still moist. The investigators isolated Curvularia from an air sample taken from the supply room. They also discovered that air was flowing into the operating room associated with the contamination, rather than out of it as infection control guidelines stipulate. Furthermore, sterile saline was poured into a bowl in the operating room before the patient arrived and left exposed to the air until it was drawn into a syringe and injected into the implants.
The investigators concluded that "ambulatory or outpatient surgical centers need to: (1) follow hospital recommendations for regular maintenance of HVAC systems and balancing of airflow in operating rooms; (2) follow infection control guidelines; and (3) include infection control staff in all stages of planning, construction, or renovation of healthcare facilities and HVAC systems." They recommended as well that operating rooms be maintained at positive airflow pressure and that surgeons should always use closed systems to fill breast implants.
Steve Baragona | EurekAlert!
The most recent press releases about innovation >>>
Die letzten 5 Focus-News des innovations-reports im Überblick:
An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.
Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...
Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.
Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...
Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.
As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...
Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.
With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...
Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine
Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...