American Association of Plastic Surgeons

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Doxycycline-Coated Breast Implants Significantly Reduce Inflammation after Bacterial Infection
Jennifer E. Baker, MD, Mitchell Skinner, BS, Aaron P. Seitz, MD, William J. Kitzmiller, MD, Michael J. Edwards, MD, Erich Gulbins, MD, PhD, Ryan M. Gobble, MD.
University of Cincinnati, Cincinnati, OH, USA.

Purpose
Surgical site infection remains one of the leading causes of re-hospitalization after a surgical procedure. Breast implants pose a specific threat due to subclinical infections and biofilm development, making bacterial eradication nearly impossible and often requiring implant removal. We have demonstrated that doxycycline-coated silicone implants significantly reduce surgical site infection and hypothesize that these implants will significantly reduce inflammation.
Methods
Pieces of silicone were coated using a novel method with doxycycline. Wildtype mice underwent subcutaneous implantation with either uncoated or doxycycline-coated silicone breast implants and surgical pockets were inoculated with methicillin-resistant Staphylococcus aureus (MRSA) or Pseudomonas aeruginosa (PA). After 3 or 7 days, mice were sacrificed and the muscle underlying the implant was harvested and homogenized. Enzyme-linked immunosorbent assays were performed for IL1β, IL4, IL6, IL10, KC, TNFα, TGFβ, and IFNγ.
Results
After 3 days, a significant reduction in IL1β and KC in the doxycycline-coated silicone implant cohort after MRSA and PA infection was demonstrated. A significant reduction in TGFβ and significant increase in IL-10 was demonstrated with the doxycycline-coated silicone implant cohort after PA inoculation and 3 days. At 7 days, a significant reduction in IL1β and TGFβ was demonstrated in the doxycycline-coated silicone implant cohort after MRSA and PA inoculation. IFNγ and IL4 were significantly reduced after PA inoculation in the uncoated silicone implant cohort.
Conclusions
Doxycycline-coated silicone breast implants significantly reduce inflammation after bacterial inoculation as compared to uncoated silicone implants. By reducing inflammation, wound healing and fibrosis may be affected, leading to less scar formation.


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