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Triple Antibiotic Solution for Capsular Contracture

During  Dr.  Adams’ plastic surgery  residency in the  mid  90’s he  became interested in breast implant research and development and capsular contracture, which for the past  60  years has been the  single  largest risk  for  breast implant based surgery. Triple Antibiotic Solution arose from a career long research focus of Dr. Adams.   This solution is used in surgery to reduce the  risk of capsular contracture.   Patients and surgeons around the world have benefitted from this Triple Antibiotic Solution research since 1999.

Capsular contracture is a hardening of the breast  that for many years had an unknown  cause.    In the  1990’s the  subclinical infection theory gained popularity.  This hypothesized that the  hardening was  caused by inflammation due to  a  colonization of bacteria around the  breast implant.

Due to this theory that was championed by Boyd Burkhardt, a plastic surgeon from Arizona, surgeons typically irrigated the breast implant pockets with antibiotic irrigation solutions; however, there was no standardization in this practice as to  what type of antibiotic solutions worked  best.  In  3  consecutive  landmark publications Dr Adams was the lead author/ investigator  in  researching  methods to optimize antibiotic irrigation practice.   The  study found specific antibiotic combinations were  superior in  broad spectrum bacterial coverage and reduction in capsular contracture.  In the  pivotal  clinical study, using these anti-biotic irrigation techniques the  capsular contracture rates were 1.8% compared to  typical rates in FDA clinical trials of 10-15 % in  aesthetic breast surgery  and 20-30%  in breast reconstruction.

Due to the findings of this study  surgeons across the world have adopted these  breast pocket irrigation techniques to make breast implant based  procedures (both  cosmetic and reconstructive) better and safer  for patients.

The publication citation is:
Adams, Rios, Smith,  Plast Reconstr Surg.,  January 2006.

Enhancing Patient Outcomes in Aesthetic and Reconstructive Breast Surgery using Triple Antibiotic Breast Irrigation – 6 years Prospective Clinical Study

Capsular contracture is a hardening of the breast due to a bacterial colonization around an implant. This causes the capsule that normally forms around the implant to gradually tighten and squeeze the implant. This can form over several months or years; a breast can change shape, harden or become painful. Severe capsular contracture is not common but it may require surgical removal of one or both breast implants.

Capsular contracture is one of Dr. Adams’ primary research focuses. He has developed several techniques to help prevent capsular contracture, and continues to develop other techniques that will hopefully minimize this risk. Dr. Adams utilizes several state of the art intra-operative techniques to help prevent this from occurring. The incidence of capsular contracture in breast implants can be quite low when specific measures are taken.

This study was the culmination of research since 1996.   The original publications were in  2000 and  2001 and  then in  Fall/ Winter of 2005 the  clinical study confirming advances in  breast augmentation and breast implants for  aesthetic and  reconstructive breast surgery.

Capsular contracture remains to be the most common implant related complication in breast augmentation and breast lift procedures involving breast implants.  Dr. Adams has  published this landmark study in the  January 2006 issue of Plastic and  Reconstructive Surgery, the premier Plastic Surgery journal in the  specialty worldwide.

“This  study  culminates the  past 8 years of  work we have done on capsular contracture and   how we  can  make  breast augmentation and  breast implant  procedures safer  and  better for patients”  says Dr. Adams the Dallas based breast specialist.   Dr. Adams and his colleagues have previously published recommendations to minimize capsular contracture using defined combinations of antibiotic solutions and refined techniques.

“These previous studies were in vitro (test tube) studies and the November publication reviews the 6 year clinical results in patients using these techniques,” says. Adams. “The results demonstrate that the patients in this study had a 4-5 fold lower capsular contracture rate than the best data compiled for FDA breast implant clinical trials.”

The benefits to potential patients for both aesthetic and reconstructive breast surgery are significant.  The  study also  demonstrated that in addition to  the  reduction in  capsular  contracture the   overall  patient re-operation rates were 2.8% compared to  15-20%  seen in  PMA breast implant  clinical trials over the  past 2 decades.  “Using these advances in breast implant patients can have better and safer results including reduced infections.”



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