Pompei Stefano, Arelli Floriana, Labardi Lara, Marcasciano Fabio, Evangelidou Dora, Ferrante Gianluigi
Dr Pompei is Head of the Plastic and Reconstructive Surgery Unit, and Drs Arelli, Labardi, and Marcasciano are Consultant Plastic Surgeons, San Camillo Hospital, Rome, Italy. Dr Evangelidou is a Plastic Surgeon, Emirates Hospital Group Plastic and Reconstructive Surgery Department, Dubai, United Arab Emirates. Dr Ferrante is a Researcher, National Institute of Health, Rome, Italy.
Aesthet Surg J. 2017 Feb;37(2):171-176. doi: 10.1093/asj/sjw183. Epub 2016 Dec 9.
Capsular contracture (CC) is a major complication of breast surgery with smooth and textured implants. Polyurethane (PU) foam-coated breast implants were developed to decrease the incidence of CC.
The authors determined the incidence of CC following 2-stage breast reconstruction using PU foam-covered implants, with and without radiation therapy.
The records of 92 patients who received 115 PU implants were retrospectively reviewed. The rates of CC over time were compared for irradiated and nonirradiated groups with a Kaplan-Meier analysis and log-rank test. CC rates also were analyzed with respect to age.
The median follow-up time for patients was 103.3 months. Nine patients experienced unilateral Baker grade III or IV fibrous CC, including 6 patients from the irradiated group and 3 patients from the nonirradiated group. The overall cumulative incidence of CC at 9 years was 8.1%. In the irradiated and nonirradiated groups, the 9-year cumulative incidence was 10.7% and 5.5%, respectively. CC occurred within 3 years in the irradiated group and within 7 years in the nonirradiated group. The incidence of CC appeared to be higher among younger patients.
Radiation therapy increases the risk of high-grade CC with textured or smooth implants. PU implants are associated with a much lower cumulative incidence of CC following 2-stage breast reconstruction, even when radiotherapy is performed. LEVEL OF EVIDENCE 3.
包膜挛缩（CC）是使用光面和毛面乳房植入物进行乳房手术的主要并发症。开发聚氨酯（PU）泡沫涂层乳房植入物以降低CC的发生率。
作者确定了使用PU泡沫覆盖的植入物进行两阶段乳房重建后CC的发生率，无论是否进行放射治疗。
回顾性分析92例接受115枚PU植入物患者的记录。采用Kaplan-Meier分析和对数秩检验比较照射组和未照射组随时间的CC发生率。还分析了CC发生率与年龄的关系。
患者的中位随访时间为103.3个月。9例患者出现单侧Baker III级或IV级纤维性CC，其中照射组6例，未照射组3例。9年时CC的总体累积发生率为8.1%。在照射组和未照射组中，9年累积发生率分别为10.7%和5.5%。照射组CC发生在3年内，未照射组发生在7年内。CC发生率在年轻患者中似乎更高。
放射治疗会增加使用毛面或光面植入物时发生高级别CC的风险。PU植入物在两阶段乳房重建后CC的累积发生率要低得多，即使进行了放射治疗。证据级别3。
