Ensuring Equal Implantation Conditions on Both Sides During Breast Augmentation: Effective Decontamination of Implantation Funnels.

Background: The role of mitigation strategies to decrease contamination during breast implant surgery has advanced over the years, and the utility of implantation funnels has been recently validated by several studies. However, the additional cost of using separate funnels for each breast has led surgeons to use the same funnel on both sides, which increases the risk of microbial contamination and complications such as capsular contracture in the second breast.

Methods: This prospective study included ten consecutive patients undergoing primary breast augmentation. The sterility of the funnels was initially confirmed by microbiological analysis of samples taken from the tip of the funnel immediately after opening. After implantation in the right breast, a second sample set was taken from the funnel. The funnel was then decontaminated using a 2% chlorhexidine with 70% isopropyl alcohol solution, air-dried, and a third sample from the tip was taken. The decontaminated funnel was then used for the left breast implantation. These three samples were analyzed for microbial contamination.

Results: Initial funnel samples were found to be sterile, meeting the manufacturer's sterility standards. However, after the initial use, all samples were contaminated with microorganisms (Staphylococcus epidermidis in seven cases and Cutibacterium acnes in three cases). Following chlorhexidine treatment, all samples were found sterile, demonstrating the effectiveness of the decontamination process.

Conclusion: Reusing a single funnel for both breast implants increases the risk of microbial contamination in the second breast. However, treating the funnel with a chlorhexidine-isopropyl alcohol solution effectively restores sterility, reducing contamination risks and maintaining cost-effectiveness. This decontamination process offers a viable and cost-effective solution for enhancing patient safety and reducing complications in breast implant surgery.

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