Bromsgrove, London, and Leicester, United Kingdom; and Rome, Italy From Dolan Park Hospital; the III° Surgical Clinic, Department of Surgical Sciences, University "La Sapienza" of Rome; the Department of Surgery, University Tor Vergata; Barts and the London School of Medicine and Dentistry; and the Department of Surgery, University Hospitals of Leicester.
Plast Reconstr Surg. 2009 Dec;124(6):1808-1819. doi: 10.1097/PRS.0b013e3181bf7f26.
The aim of this article was to review the current literature on capsular contractures, focusing in particular on the epidemiology, risk factors, cause, and treatment modalities, to provide the plastic surgeon with an up-to-date review of the current available evidence.
A literature search was undertaken of the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases. The search strategy was conducted using three groups of key words, with the first relating to the organ involved (breast), the second relating to the surgical procedure performed and related technical issues, and the third relating to the surgical complications. Potentially relevant articles were identified by means of the title and the abstract, and full articles were obtained and assessed in detail.
Only a few studies have included large enough sample sizes, were conducted in a prospective manner, were adequately randomized, and achieved adequate follow-up periods to obtain a true measure of rates of capsular contraction occurrence. Recent advances in molecular biology, microbiology, immunology, and basic pathology have outlined some of the mechanisms that underlie this phenomenon. Revision surgery remains the only effective treatment option available but is limited by its high associated risk of recurrences. No adequate preventative measures exist in practice, beyond the avoidance of risk factors.
Although a great deal of progress has been made over the past few decades, the exact nature and contribution of molecular, immunologic, and microbiological factors remain unclear. It is hoped that future studies will focus on attempting to resolve some of the issues highlighted in this review.
本文旨在回顾目前有关包膜挛缩的文献，重点关注其流行病学、风险因素、病因和治疗方法，为整形医生提供当前有关现有证据的最新综述。
对 MEDLINE、EMBASE 和 Cochrane 中心对照试验注册库进行文献检索。检索策略采用三组关键词，第一组与涉及的器官（乳房）有关，第二组与手术程序及相关技术问题有关，第三组与手术并发症有关。通过标题和摘要确定潜在相关文章，并获取全文并进行详细评估。
仅有少数研究纳入了足够大的样本量、采用前瞻性方法、充分随机化且随访时间足够长，以真实评估包膜收缩发生率。分子生物学、微生物学、免疫学和基础病理学的最新进展概述了构成这一现象的一些机制。翻修手术仍然是唯一有效的治疗选择，但由于其高复发风险而受到限制。除了避免风险因素外，目前尚无有效的预防措施。
尽管在过去几十年中取得了很大进展，但分子、免疫和微生物因素的确切性质和贡献仍不清楚。希望未来的研究将集中于尝试解决本综述中强调的一些问题。
