A Novel Approach for Preventing Biofilm Formation on Various Breast Implant Surfaces: Bacteriophage Therapy.

[BACKGROUND] Capsular contracture is a common complication in breast implant surgery, with subclinical bacterial inflammation being a significant factor. Traditional methods to prevent capsular contracture include antibiotic irrigation and systemic antibiotics. However, the rise of antibiotic-resistant bacteria has driven the need for alternative treatments. Bacteriophages, capable of lysing bacteria and preventing biofilm formation, are emerging as a potential alternative. This study aimed to compare the efficacy of local bacteriophage therapy and local antibiotic treatment in preventing biofilm formation on breast implants.

[METHODS] Fifty-four Wistar Albino rats were divided into 3 groups: control, antibiotic, and bacteriophage, each with 3 subgroups for different time points (6 hours, 24 hours, and 30 days). Three types of implant surfaces (smooth, textured, and polyurethane) were incubated with a biofilm-producing strain of Staphylococcus epidermidis before implantation. The implant surfaces in the experimental groups were treated with either antibiotic or bacteriophage solutions before implantation. Samples were collected at 6 hours, 24 hours, and 30 days after implantation for colony counting and mRNA analysis of the sesI gene.

[RESULTS] Both bacteriophage and antibiotic treatments significantly reduced colony counts and mRNA expression compared with the control group at all time points ( P < 0.05). No significant difference was found between the antibiotic and bacteriophage groups. Textured and polyurethane implants showed lower bacterial loads in the experimental groups compared with smooth implants.

[CONCLUSION] This study highlights bacteriophages as a promising alternative to antibiotics for preventing biofilm formation on breast implants, representing a pioneering effort in demonstrating their potential.

[CLINICAL RELEVANCE STATEMENT] Bacteriophages are promising in the fight against bacteria. They can penetrate biofilm and effectively treat infections. They could be an alternative to antibiotic treatments.