Department of Plastic and Aesthetic Surgery, Southwest Hospital, Third Military Medical University, Chongqing, China.
Med Sci Monit. 2012 Jun;18(6):CR399-408. doi: 10.12659/msm.882910.
Increasing complications of polyacrylamide hydrogel (PAAG) augmentation mammoplasty, such as chronic persistent infection, have recently caught the attention of both the medical field and the general public.
MATERIAL/METHODS: A total of 96 patients with severe chronic infection following PAAG augmentation mammoplasty were treated in the present study including 63 cases with infection confined to the breast and 33 with systemic infection. Endoscopy and surgery were performed to completely remove the materials and clear the infected tissues followed by drug-irrigation and vacuum-assisted closure for several days.
In patients with severe infection there were large amounts of PAAG, fibers and infiltration of numerous neutrophils and macrophages. The infection-inducing materials were extensively dispersed in the mammary and subcutaneous tissues, pectoral fascia and intermuscular space. In addition, there was scattered distribution of PAAG materials in the armpit, chest wall and abdominal wall, which were mixed with necrotic tissues and surrounded by lymphocytes, giant cells, macrophages and other inflammatory cells, forming chronic granulomatous and fibrous lesions. Infection was controlled following surgical intervention. No residual infectious foci or recurrent infections were noted among these patients. Although the severe infection did not result in mastectomy, patients had breast atrophy and various degrees of deformation.
Chronic infection following PAAG augmentation mammaplasty usually causes systemic infection and other devastating adverse reactions. This study confirms PAAG augmentation mammaplasty is another failed attempt. More attention should be paid to the injection of large doses of liquid filler.
聚丙酰胺水凝胶（PAAG）隆乳术后并发症日益增多，如慢性持续性感染，近期受到医学界和公众的广泛关注。
材料/方法：本研究共治疗 96 例 PAAG 隆乳术后严重慢性感染患者，其中感染局限于乳房 63 例，全身感染 33 例。采用内镜及手术彻底清除材料及感染组织，冲洗后行负压封闭引流数天。
严重感染患者的 PAAG、纤维及大量中性粒细胞和巨噬细胞浸润。感染诱导材料广泛分布于乳腺和皮下组织、胸大肌筋膜和肌间间隙。此外，腋窝、胸壁和腹壁也有 PAAG 材料的散在分布，与坏死组织混合，并被淋巴细胞、巨细胞、巨噬细胞等炎性细胞包围，形成慢性肉芽肿和纤维性病变。经手术干预后感染得到控制。这些患者均无残留感染灶或复发感染。尽管严重感染未导致乳房切除术，但患者出现乳房萎缩和不同程度的变形。
PAAG 隆乳术后慢性感染常引起全身感染和其他严重不良反应。本研究证实 PAAG 隆乳术又是一次失败的尝试。应更加关注大剂量液体填充物的注射。
