Microbial biofilms on silicone facial prostheses

Facial disfigurements can result from oncologic surgery, trauma and congenital deformities. These disfigurements can be rehabilitated with facial prostheses. Facial prostheses are usually made of silicones. A problem of facial prostheses is that microorganisms can colonize their surface. It is hard for the patient to effectively clean the surface of the prosthesis that is in contact with the skin which may cause, amongst others, skin irritation. Besides skin irritation, microorganisms that colonize the surface of the prostheses are also thought to cause degradation of the silicone material and change the color of the prostheses. In about one third of facial prostheses that have to be renewed, discoloration was the main reason to make a new prosthesis. We have observed that skin covered with facial prostheses is more prone to colonization with bacterial and fungal pathogens than healthy skin. Since routine cleansing methods that rely on mechanical cleansing cannot eradicate microorganisms completely, as shown by scanning electron microscopy examination of worn prostheses, there is a need for more effective cleansing methods. Thus, the renewal frequency of facial prostheses can be reduced along with the need for antibiotics and anti-inflammatory drugs to control adverse skin reactions. We showed that chlorhexidine and essential-oil mouthrinses are effective in reducing microorganisms on the surface of silicone facial prostheses. These easily obtainable consumer products might be an effective aid in decreasing the incidence of adverse skin reactions and make the prostheses usable for a longer period of time