Kjøller K, Hölmich L R, Jacobsen P H, Friis S, Fryzek J, McLaughlin J K, Lipworth L, Henriksen T F, Jørgensen S, Bittmann S, Olsen J H
Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen.
Ann Plast Surg. 2001 Oct;47(4):359-66. doi: 10.1097/00000637-200110000-00001.
The authors investigated the association between the occurrence of capsular contracture and implant and patient characteristics. All women with breast implants from 1977 to 1997 were identified from the files of two private plastic surgery clinics in Denmark. Information on implant and patient characteristics, surgical procedure, and complications was obtained through medical records and self-administered questionnaires. Of 754 women (1,572 implants), average age at implantation was 32 years. Implant types were silicone double lumen, textured, 31.2%; silicone single lumen, textured, 27.8%; silicone single lumen, smooth, 24.5%; silicone double lumen, smooth, 0.8%; and other or missing, 15.7%. Placement was submuscular for more than 90% of implants. Capsular contracture occurred in 7.9% of implanted breasts, on an average of 621 days postoperatively, with 51.6% being bilateral. Overall, 66.1% of capsular contractures were recorded within the first 12 months postoperatively, and 79.0% were recorded within 24 months. Double-lumen implants were associated with a significantly (p < 0.01) reduced occurrence of capsular contracture. In summary, capsular contracture typically occurs within the first 2 years of implantation. Host factors may be important because more than half the capsular contractures in the current study were bilateral. Occurrence of capsular contracture did not appear to be associated with implant surface or placement, occurrence of local complications, or patient characteristics, although these findings should be interpreted cautiously.
作者研究了包膜挛缩的发生与植入物及患者特征之间的关联。从丹麦两家私立整形外科诊所的档案中识别出1977年至1997年期间所有植入乳房假体的女性。通过病历和自行填写的问卷获取了有关植入物、患者特征、手术过程及并发症的信息。在754名女性(1572个植入物)中,植入时的平均年龄为32岁。植入物类型为:硅酮双腔、带纹理的,占31.2%;硅酮单腔、带纹理的,占27.8%;硅酮单腔、光滑的,占24.5%;硅酮双腔、光滑的,占0.8%;其他或缺失的,占15.7%。超过90%的植入物置于胸大肌下。7.9%的植入乳房发生了包膜挛缩,平均在术后621天出现,其中51.6%为双侧。总体而言,66.1%的包膜挛缩发生在术后12个月内,79.0%发生在24个月内。双腔植入物与包膜挛缩发生率显著降低(p<0.01)相关。总之,包膜挛缩通常发生在植入后的头2年内。宿主因素可能很重要,因为在本研究中超过一半的包膜挛缩是双侧的。包膜挛缩的发生似乎与植入物表面或放置位置、局部并发症的发生或患者特征无关,尽管对这些发现应谨慎解读。