A short YouTube video by Robert Whitfield MD presenting a single explant surgery case: a patient (ICU nurse) traveled from New Orleans to Austin for implant removal due to profound fatigue. Clinical labs (white blood cell count) were normal and she lacked overt signs of infection, but intraoperative findings showed a slime layer on the implant that the speaker identifies as bacterial biofilm (distinguished from gel bleed or shell degradation). The speaker emphasizes occupational exposure risk and a prodromal phase where patients appear non-infected.
Chapters
That is a very worrisome client for me to get. I'm sorry. Q4 of 18. I had a patient come from New Orleans to Austin for an explant because she had family here, wanted to stay with her family and have her surgery. Her background was she was an ICU nurse. And you and I both know what kind of exposure risk that puts you in. When you've been in nursing for a long period of time, you basically see everything and get exposed to everything. That is a very worrisome client for me to get because they've been exposed to all sorts of things. And she had a lot of fatigue, a lot. And so I presume she was infected based on that previous experience, plus her occupation and what she was describing. And no laboratory abnormalities? No. No change in her white blood cell count for the audience, because we always look for that. Right. So these people don't look infected. They don't act infected. They're. They. They're in the prodromal phase of infection. So they're before infection. So I took this patient to the or did her explant, and she had just a slime layer on her implant. And so for the audience, the. You'll hear things called gel bleed, which is implant material that silicone leaking out or the destruction of. We'll say the shell is just disintegrating, but this is actually bacterial biofilm.
