Brohim R M, Foresman P A, Hildebrandt P K, Rodeheaver G T
Plastic Surgery Research, University of Virginia Health Sciences Center, Charlottesville, VA.
Ann Plast Surg. 1992 Apr;28(4):354-62. doi: 10.1097/00000637-199204000-00010.
Capsular contracture around breast implants with smooth surfaces continues to be an unpredictable complication. Some surgeons believe that silicone implants covered with porous polyurethane foam have a lowered potential to contract. These textured implants are not as biocompatible as silicone. Recently, silicone implants with textured surfaces have been introduced with the hope that the incidence of unacceptable implant contracture will be reduced. Using a rat implant model, the tissue reaction to textured implant surfaces was assessed. The implant surfaces evaluated were Silastic II, Siltex, MISTI, Biocell, Silastic MSI, and Même. Disks of each implant material were implanted under the dorsal skin of rats for a period of 28 days. Each implant with its surrounding tissue was excised, processed for histological analysis, and assessed for the tissue's response to the implant with particular emphasis on the formation of a continuous collagen capsule. The results indicated that the magnitude of surface texturing influenced the development of a complete capsule. Implant surfaces with a texture of less than 150 microns in height or depth (Silastic II, Siltex, and MISTI) resulted in the formation of complete capsules. An implant (Biocell) with irregular texturing (200-350 microns) produced an organized capsule over most of its surface with localized interruptions of the capsule at the sites of its deepest cavities. Implant surfaces with texturing that exceeded 350 microns in height or depth (Silastic MSI and Même) resulted in inhibition of the formation of a continuous capsule during this 28-day study.
表面光滑的乳房植入物周围的包膜挛缩仍然是一种不可预测的并发症。一些外科医生认为，覆盖有多孔聚氨酯泡沫的硅胶植入物发生挛缩的可能性较低。这些有纹理的植入物的生物相容性不如硅胶。最近，已推出表面有纹理的硅胶植入物，以期降低不可接受的植入物挛缩的发生率。利用大鼠植入模型，评估了组织对有纹理的植入物表面的反应。所评估的植入物表面有Silastic II、Siltex、MISTI、Biocell、Silastic MSI和Même。将每种植入材料的圆盘植入大鼠背部皮肤下28天。切除每个植入物及其周围组织，进行组织学分析，并评估组织对植入物的反应，特别关注连续胶原包膜的形成。结果表明，表面纹理的程度影响了完整包膜的形成。高度或深度小于150微米的纹理的植入物表面（Silastic II、Siltex和MISTI）导致形成完整的包膜。具有不规则纹理（200 - 350微米）的植入物（Biocell）在其大部分表面产生了有组织的包膜，在其最深腔隙部位包膜有局部中断。在这项为期28天的研究中，高度或深度超过350微米的纹理的植入物表面（Silastic MSI和Même）导致连续包膜形成受到抑制。
