Internal hemorrhoid banding 2 weeks after breast augmentation - Higher risk for capsular contracture?

Question

I was not aware of the fact that I should have asked for antibiotics before doing procedures other than dental work. So I had an internal hemmorhoid banded which is called rubber band ligation. Does this create a bacterial infection or Capsular contraction risk?

Otto Joseph Placik, MD · Answer

It is not so much that banding will cause bacterial infection as it will cause bacteremia with possible seeding of the implant and subsequent biofilm formation which has been associated with the development of capsular contractuire. Perioperative antibiotics, similar to dental work, may diminish this risk.

John LoMonaco, MD, FACS · Answer

Teeth cleaning, and probably any manipulation of the GI tract (from mouth to anus) is known to cause bacterial translocation.  My guess is that placement of the protoscope and manipulation of the lower GI tract during a hemorrhoidectomy or banding may do the same.

	There is no agreement on antibiotics in these situations.  I recommend that my patients take them prior to teeth cleaning, etc., if they have had an issue with contracture before.  Most orthopedic surgeons who have patients with artificial joints are very compulsive about this, however, as infection of their implants can cause a lot of problems!

Peter A. Aldea, MD · Answer

The body will wrap any foreign body (implants, shunts, bullets, shrapnel) with a barrier of scar tissue. But in some cases the scar tissue grows progressively thicker and squeezes the implant to the point of pain and breast deformation (Baker IV class contracture).

	Causal factors associated with capsular contracture have been foreign bodies in the implant pockets, blood and bacteria. It has been demonstrated that the seeding of bacteria into the blood from dental work could cause capsular contracture.

	Logically then any condition in which bacteria can enter the blood, even temporarily, in theory could reach the implants and set in motion events that MAY lead to capsular contracture. This would include decrease or loss of immunity and any instrumentation of the lower GI tract.

	Although there is no hard proof that antibiotics would prevent a capsular contracture, if there are no allergies to prevent using them, I prefer to prescribe them knowing just how cheap 2 doses (before and after) of antibiotics are when compared to the emotional and financial cost of capsular contracture and its treatment.

Internal hemorrhoid banding 2 weeks after breast augmentation - Higher risk for capsular contracture?

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Internal hemorrhoid banding 2 weeks after breast augmentation - Higher risk for capsular contracture?

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