July 15, 2005

Silicone breast implants may be contaminated-study

By Will Boggs, MD

NEW YORK (Reuters Health) - Five cases of fungal
contamination of saline-filled breast implants were likely
caused by poor infection control measures during the implant
procedures and in the operating room, according to a report.

According to investigators, black sediment was seen in the
implants of five women who had undergone a second surgery to
correct various problems they were having with their breast

A fast-growing fungus found in soil called Curvularia
fungus was isolated from the saline in the removed implants,
Dr. Marion A. Kainer, from the Tennessee Department of Health
in Nashville, and colleagues report in The Journal of
Infectious Diseases.

One surgeon operating in a freestanding same-day surgery
center performed all five procedures. Many of these centers do
not have infection control experts on staff to ensure that
infection control guidelines are being followed, Kainer told
Reuters Health.

Careful investigation of the surgical center revealed a
number of problems that could have contributed to the
contaminated implants including negative pressure in the
operating room relative to the outside room as well as warm
conditions supporting the growth and spread of the fungus. The
surgeon also filled the implant with saline using an open-bowl
technique -- a no-no.

"This outbreak," the investigators say, "provides
scientific evidence to support the recommendation that
operating rooms should be at positive pressure relative to the
surrounding areas and that a closed system should be used when
injecting sterile saline into...breast implants."

"Surgery center infection control measures," the team adds,
"must include moisture control and balanced ventilation

SOURCE: Journal of Infectious Diseases July 1, 2005.