Bern S, Burd A, May J W
Department of Surgery, Massachusetts General Hospital, Boston.
Plast Reconstr Surg. 1992 Jun;89(6):1037-42; discussion 1043-4.
Capsular contracture remains the major complication of reconstructive and aesthetic breast surgery. The purpose of this investigation was to determine if a silicone implant with a textured surface will form a capsule of significantly different biophysical and histologic properties than conventional smooth silicone. Thirty smooth and 30 textured silicone tissue expanders were implanted under the panniculus carnosus of rabbits. After 3 months, measurements related to contracture were performed on anesthetized animals in an investigator-blinded, controlled manner. Intraexpander pressures were measured as saline was injected over time. We found a significant correlation between intraexpander pressures, applanation tonometry, and Baker class. Histology revealed a thicker, more adherent, and inflammatory capsule around the textured silicone implants as compared with the smooth silicone implants. Dynamic pressures were plotted against volume of saline within the two types of implants. Statistical analysis revealed that the textured implants form a tighter and thicker capsule than the smooth implants after 3 months of observation (p less than 0.005).
包膜挛缩仍然是乳房重建手术和美容手术的主要并发症。本研究的目的是确定具有纹理表面的硅胶植入物是否会形成与传统光滑硅胶具有显著不同生物物理和组织学特性的包膜。将30个光滑的和30个有纹理的硅胶组织扩张器植入兔的腹直肌下。3个月后，以研究者盲法、对照的方式对麻醉的动物进行与挛缩相关的测量。随着时间的推移注入生理盐水时测量扩张器内的压力。我们发现扩张器内压力、压平眼压计测量值和贝克分级之间存在显著相关性。组织学显示，与光滑硅胶植入物相比，有纹理的硅胶植入物周围的包膜更厚、更粘连且有炎症。绘制了两种类型植入物内的动态压力与生理盐水体积的关系图。统计分析显示，观察3个月后，有纹理的植入物比光滑的植入物形成更紧密、更厚的包膜（p小于0.005）。
