Robert Whitfield MD explains why he removes the entire capsule during explant surgery. Bacterial biofilm, particularly Cutibacterium acnes, coats devices and shields itself from the immune system, making preoperative testing unreliable for detecting contamination.
When I found you, I had already. This is just, I mean, the divine intervention here. I had already scheduled with another surgeon, an explant. Thank goodness that it was kind of had a halt because I was on heavy steroids for three months due to my colitis. Went in for my pre op and she said, wait, you've been on steroids. You have to be off 60 days or you won't heal. And I was like, what? Devastated. Devastated. That was. She did not remove the capsule. That was not her protocol. Can you explain why it's so important to remove the capsule?
So I think there's already been papers published that show how very high amounts of biofilm. So biofilm, we'll just say in this setting, are bacterial contaminants. So these things can get attached to devices. Now the most common thing that we see is a bacteria called cutie bacteria, bacterium, actus. Everybody knows this. This is not new. It's in the literature, it's been talked about ad nauseam. This bacteria readily creates biofilm and biofilm helps protect it from your body's immune system. So instead of taking it away, it China sits there and battles it. All of those are concerning. If a third of them have biofilm, I can't tell you upfront who has that problem. So I take everything out and try to be consistent in.
