LAUSR

BACKGROUND Specific antimicrobial breast pocket irrigations have been proven to reduce capsular contracture by 10x over the past 20 years, and with the emergence of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) and its link to bacteria/technique there has been a renewed interest in different ant-microbial breast pocket preparation agents. Our previous studies have identified both Betadine containing and non-Betadine containing antimicrobial irrigations that provide excellent broad-spectrum bacterial coverage. The current science of BIA-ALCL has implicated the gram-negative microbiome as a key in pathogenesis. OBJECTIVES The purpose of this study is to revisit the antimicrobial effectiveness of clinically utilized Betadine and non-Betadine solutions, along with other antimicrobial agents that have not yet been tested, against multiple organisms, including additional common gram-negative bacteria associated with chronic breast implant infections/inflammation. METHODS Using standardized technique current and new anti-microbial breast irrigations were tested for bactericidal activity vs. multiple gram-positive and gram-negative strains. Test results are detailed and clinical recommendation for current anti-microbial irrigations are provided. RESULTS Betadine containing irrigations performed superior in the testing. CONCLUSION There are quite few misnomers with regard to anti-microbial breast pocket irrigation. These are discussed and final evidence-based recommendation for practice are given.