Luvsannyam Enkhmaa, Patel Dhara, Hassan Zaira, Nukala Swetha, Somagutta Manoj R, Hamid Pousette
Department of Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Neurology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Cureus. 2020 Sep 9;12(9):e10341. doi: 10.7759/cureus.10341.
Capsular contracture is one of the most common complications of implant-based breast reconstruction or augmentation surgery. Despite advanced molecular biology, the exact mechanism of this complication is not fully understood. PubMed was searched for studies, published from 2015 to 2020, focused on potential risk factors and preventions of capsular contracture (CC) in patients who underwent implant-based breast surgery. A total of 533 articles were identified from PubMed, and 13 articles were selected ultimately for our review after eligibility screening and quality appraisal. Common risk factors of CC include biofilm, surgical site infections (SSI), history of prior CC or fibrosis, history of radiation therapy, and implant characteristics. Interventions that decrease the rate of CC include antibiotic prophylaxis or irrigation, acellular dermal matrix (ADM), leukotriene (LTE) inhibitors, surgical techniques, and others. Multiple risk factors are proposed to be a component of the pathophysiology of CC. However, there is inconsistent evidence supporting these risk factors, and the current data was based on broad heterogeneous studies. While efforts are being undertaken to solve this complication with improved technologies and surgical practices, CC remains to be unsolved. Our objective was to provide a summary of the current data of contributing risk factors as well as preventative and treatment measures for CC.
包膜挛缩是基于植入物的乳房重建或隆胸手术最常见的并发症之一。尽管分子生物学取得了进展，但这种并发症的确切机制尚未完全明确。检索了PubMed上2015年至2020年发表的聚焦于接受基于植入物的乳房手术患者包膜挛缩（CC）潜在危险因素及预防措施的研究。从PubMed上共识别出533篇文章，经过资格筛选和质量评估后，最终选定13篇文章进行综述。CC的常见危险因素包括生物膜、手术部位感染（SSI）、既往CC或纤维化病史、放射治疗史以及植入物特性。降低CC发生率的干预措施包括抗生素预防或冲洗、脱细胞真皮基质（ADM）、白三烯（LTE）抑制剂、手术技术等。多种危险因素被认为是CC病理生理学的组成部分。然而，支持这些危险因素的证据并不一致，且目前的数据基于广泛的异质性研究。尽管人们正努力通过改进技术和手术操作来解决这一并发症，但CC仍然难以解决。我们的目的是总结CC相关危险因素以及预防和治疗措施的当前数据。
