Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria.
Int J Mol Sci. 2024 Oct 30;25(21):11675. doi: 10.3390/ijms252111675.
Silicone mammary implants (SMIs) frequently result in capsular fibrosis, which is marked by the overproduction of fibrous tissue surrounding the implant. This review provides a detailed examination of the molecular and immunological mechanisms driving capsular fibrosis, focusing on the role of foreign body responses (FBRs) and microbial biofilm formation. We investigate how microbial adhesion to implant surfaces and biofilm development contribute to persistent inflammation and fibrotic responses. The review critically evaluates antimicrobial strategies, including preoperative antiseptic protocols and antimicrobial-impregnated materials, designed to mitigate infection and biofilm-related complications. Additionally, advancements in material science, such as surface modifications and antibiotic-impregnated meshes, are discussed for their potential to reduce capsular fibrosis and prevent contracture of the capsule. By integrating molecular insights with clinical applications, this review aims to elucidate the current understanding of SMI-related fibrotic responses and highlight knowledge gaps. The synthesis of these findings aims to guide future research directions of improved antimicrobial interventions and implant materials, ultimately advancing the management of capsular fibrosis and enhancing patient outcomes.
硅酮乳房植入物（SMIs）常导致包膜纤维化，其特征是围绕植入物的纤维组织过度生成。本综述详细检查了导致包膜纤维化的分子和免疫学机制，重点关注异物反应（FBR）和微生物生物膜形成的作用。我们研究了微生物对植入物表面的黏附和生物膜的形成如何导致持续的炎症和纤维反应。该综述批判性地评估了抗菌策略，包括术前消毒方案和抗菌浸渍材料，旨在减轻感染和与生物膜相关的并发症。此外，还讨论了材料科学的进步，如表面改性和抗生素浸渍网，以减少包膜纤维化和防止包膜挛缩。通过将分子见解与临床应用相结合，本综述旨在阐明目前对 SMI 相关纤维反应的理解，并突出知识空白。综合这些发现旨在指导改进抗菌干预措施和植入物材料的未来研究方向，最终改善包膜纤维化的管理并提高患者的治疗效果。
