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The Role of Bacterial Biofilms in Device-Associated Infection

Deva, Anand K. M.B.B.S.(Hons.), M.S.; Adams, William P. Jr. M.D.; Vickery, Karen B.V.Sc.(Hons.), Ph.D.

Plastic and Reconstructive Surgery: November 2013 - Volume 132 - Issue 5 - p 1319–1328
doi: 10.1097/PRS.0b013e3182a3c105
Special Topics

Summary: There is increasing evidence that bacterial biofilm is responsible for the failure of medical devices, leading to device-associated infection. As plastic surgeons, we are among the leading users of prostheses in surgery, and it is important that we are kept informed of this growing problem. This article summarizes the pathogenesis of device-associated infection, outlines the evidence for such infection in a number of medical devices, and outlines operative strategies aimed at reducing the risk of bacterial contamination at the time of device deployment. It also outlines strategies under investigation to combat the development of device-associated infection.

Sydney, Australia; and Dallas, Texas

From the From the Surgical Infection Research Group, Macquarie University; and the Department of Plastic Surgery, University of Texas Southwestern Medical Center.

Received for publication February 6, 2013; accepted March 7, 2013.

Disclosure: Profs. Deva and Vickery are consultants to Allergan, Mentor (Johnson & Johnson), and KCI. They have previously coordinated industry-sponsored research for these companies relating to both biofilms and breast prostheses. Dr. Adams has been an investigator for Allergan and Mentor cohesive gel investigational device exemption trials, medical director of the Mentor Corporation cohesive gel implant (Contour Profile Gel) trial from 2001 to 2007, consultant to Ethicon and Allergan, and scientific advisor to TyRx and Axis-3.

Anand K. Deva, M.B.B.S.(Hons.), M.S., Surgical Infection Research Group, Australian School of Advanced Medicine, Macquarie University, 2 Technology Place, Suite 301, Macquarie Park, Sydney NSW 2109, Australia,

©2013American Society of Plastic Surgeons