Grants We Funded

Abstract
Silicone breast implants are used in breast reconstruction for women undergoing mastectomy, and infection requires removal of the implant. Patients who fail reconstruction have more pain and a lower quality of life. Doxycycline is a tetracycline antibiotic that has activity against a broad range of bacteria and has been used therapeutically in soft tissue and vascular infections. Our group has developed a novel, cheap, simple, and effective technique for coating doxycycline onto silicone implants. Preliminary studies demonstrate that silicone implants maintain antimicrobial activity in vitro and in vivo. We hypothesize that coating silicone breast implants with doxycycline will decrease the incidence of bacterial infection. We will first demonstrate the efficacy of doxycycline-coated silicone breast implants compared to vehicle-coated controls against bacteria and examine release kinetics from doxycycline-coated silicone implants in vitro. We hypothesize that doxycycline-coated silicone breast implants will demonstrate significant resistance to bacterial colonization compared to vehicle-coated controls and that doxycycline will be stably bound to silicone implants. Next, we will investigate whether doxycycline-coated silicone breast implants prevent infection in vivo. We will use a mouse subcutaneous pocket model of implant infection to examine the effectiveness of doxycycline-coated silicone breast implants in preventing bacterial infection compared to vehicle-coated controls. We will perform bacterial titration studies and temporal studies and confirm stability of doxycycline binding to silicone implants. We will test the ability of doxycycline-coated silicone implants to prevent biofilm formation using MRI and FDG-PET imaging. We hypothesize that doxycycline-coated silicone breast implants will be able to prevent implant colonization and clear local bacterial infections even in significantly contaminated subcutaneous pockets. If the proposed experiments are successful, we will have demonstrated that coating silicone breast implants with doxycycline results in significant antimicrobial activity both in vitro and in vivo. Ultimately, our goal is to perform randomized clinical trials in breast reconstruction patients in order to study the ability of doxycycline-coated silicone breast implants in preventing infections. Coating silicone breast implants with doxycycline in order to prevent infection has the potential to revolutionize breast cancer care.

Biography
Dr. Ryan Gobble is a plastic and reconstructive surgeon at the University of Cincinnati College of Medicine in Cincinnati, OH. He has previously completed general surgery training at New York University Langone Medical Center in NY, NY. Dr. Gobble did further surgical training in plastic and reconstructive surgery at Harvard Medical School in Boston, MA. In order to study cancer and its impact on the human body Dr. Gobble has also completed a surgical oncology research fellowship at Memorial-Sloan Kettering Cancer Center in NY, NY. Dr. Gobble's main area of focus in his practice is in the care of patients undergoing breast reconstruction after mastectomy. He is interested in studying the ability of coating silicone breast implants with antibiotics in order to prevent acute breast implant infection, which lead to the removal of the breast implant, and subacute clinical infection, which is involved in the development of capsular contracture, a late cause of implant failure. Dr. Gobble believes that a significant improvement in breast cancer care can be achieved by decreasing the risk of infection in women undergoing breast reconstruction, and he is hopeful that by coating breast implants with doxycycline that he will be able to achieve this goal. Dr. Gobble’s project has received $70,000 in peer reviewed funding and been accepted for presentation at international research meetings.