Faculty of Medicine, University of Oporto, Porto, Portugal,
Aesthetic Plast Surg. 2012 Aug;36(4):986-94. doi: 10.1007/s00266-012-9888-z. Epub 2012 Apr 5.
The etiology and clinical treatment of capsular contracture remain unresolved as the causes may be multifactorial. Triamcinolone acetonide applied in the pocket during surgery was reported to be ineffective in prevention of capsular contracture. However, if injected 4-6 weeks after surgery or as a treatment for capsular contracture, decreased applanation tonometry measurements and pain were observed. It was assumed that intraoperative application of triamcinolone was not effective because its effect does not last long enough. However, betadine, antibiotics, and fibrin were found to be effective in preventing capsular contracture with intraoperative applications and are more effective in the early phases of wound healing than in later stages. The role of triamcinolone acetonide in capsule formation is unknown. The purpose of this study was to determine if triamcinolone acetonide modulates breast capsule formation or capsular contracture in the early phases of wound healing in a rabbit model.
Rabbits (n=19) were implanted with one tissue expander and two breast implants and were killed at 4 weeks. Implant pocket groups were (1) Control (n=10) and (2) Triamcinolone (n=9). Pressure/volume curves and histological, immunological, and microbiological evaluations were performed. Operating room air samples and contact skin samples were collected for microbiological evaluation.
In the triamcinolone group, a decreased capsular thickness, mild and mononuclear inflammation, and negative or mild angiogenesis were observed. There were no significant differences in intracapsular pressure, fusiform cell density, connective tissue, organization of collagen fibers, and microbiological results between the groups. There was no significant difference in the dialysate levels of IL-8 and TNF-α, but correlation between IL-8 and TNF-α was observed.
Triamcinolone acetonide during breast implantation influences early capsule formation and may reduce capsular contracture.
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包膜挛缩的病因和临床治疗仍然没有得到解决，因为其原因可能是多因素的。手术中在囊袋内应用曲安奈德被报道对预防包膜挛缩无效。然而，如果在手术后 4-6 周内注射或作为包膜挛缩的治疗方法，观察到眼压计测量值降低和疼痛减轻。人们认为手术中应用曲安奈德无效，因为其效果持续时间不够长。然而，术中应用碘伏、抗生素和纤维蛋白被发现可以有效预防包膜挛缩，并且在伤口愈合的早期阶段比后期阶段更有效。曲安奈德在胶囊形成中的作用尚不清楚。本研究的目的是确定曲安奈德是否可以调节兔模型伤口愈合早期的乳腺胶囊形成或包膜挛缩。
将 19 只兔子（n=19）植入一个组织扩张器和两个乳房植入物，并在 4 周时处死。植入袋组为（1）对照组（n=10）和（2）曲安奈德组（n=9）。进行压力/容积曲线和组织学、免疫学和微生物学评估。收集手术室空气样本和接触皮肤样本进行微生物学评估。
在曲安奈德组，观察到包膜厚度减少、轻度单核细胞炎症和阴性或轻度血管生成。两组之间的囊内压力、梭形细胞密度、结缔组织、胶原纤维组织和微生物学结果无显著差异。IL-8 和 TNF-α 的透析液水平无显著差异，但观察到 IL-8 和 TNF-α 之间存在相关性。
乳房植入物中应用曲安奈德会影响早期胶囊形成，并可能减少包膜挛缩。
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