Project Director

Spratt, Henry G., Jr.

Department Examiner

Kovach, Margaret J.


Dept. of Biological and Environmental Sciences


University of Tennessee at Chattanooga

Place of Publication

Chattanooga (Tenn.)


Breast augmentation and reconstruction procedures are among the most popular plastic surgeries in the U.S. Opportunistic bacterial pathogens introduced during surgery can lead to surgical site infections, capsular contractures, biofilm formation, and lymphoma. To prevent these infections, an antibiotic solution containing Cefazolin, Gentamicin, and Bacitracin (Adams’ Antibiotic Solution - AS) has traditionally been used for irrigation. Due to antibiotic resistant pathogens and a debate over the efficacy of irrigation by AS to reduce infections, alternatives must be found. This study considers the use of the antiseptic chlorhexidine gluconate (CHG) as an alternative irrigation solution. In vitro, we exposed pure cultures of six bacterial species known to cause infections during this surgery to: AS, CHG, or a saline control (SAL) for one, two, or five minutes in simulated breast “cavities” (test tubes). Viable plate counts carried out before and after exposure allowed calculation of the percent survival for each bacterial species. Across all time intervals, the average survival of CHG irrigated cultures was zero percent, though some growth did occur with MRSA. Survival rates following SAL irrigation were between 63.1-104%, and those following AS exposures were between 62.5-100%. Student’s t-tests suggest that differential bacterial survival for CHG and SAL treatments were significant (p < 0.05). However, comparison of bacterial survival in AS and SAL treatments were not significant (p > 0.05) in most cases. These results suggest that use of CHG for irrigation is more effective at killing potential pathogens than AS, and that AS is little different from our controls. This finding has the potential to change the standard of care in breast augmentation and reconstruction surgical procedures.


This research was funded by The University of Tennessee at Chattanooga’s Clinical Infectious Disease Control research group and The Plastic Surgery Foundation in Chattanooga. I could not have completed this work without the insight, direction, and trust from my professor and mentor, Henry Spratt, Jr., PhD, nor could it have been done without the dedication and hard work of Katie Noonan, BS and Bridget Curtin, BS. I would also like to acknowledge Mathew Epps, MD, MS; Mark Brzezienski, MD, FACS; David Levine, PT, PhD, DPT; and Margaret Kovach, PhD for their roles in the ideation and progression of this research and written work.


B. S.; An honors thesis submitted to the faculty of the University of Tennessee at Chattanooga in partial fulfillment of the requirements of the degree of Bachelor of Science.




Augmentation mammaplasty; Breast -- Surgery


Microbiology; Chlorhexidine gluconate; CHG; Breast implant; Reconstruction



Document Type



58 leaves







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Biology Commons