Asplund O, Gylbert L, Jurell G, Ward C
Department of Plastic and Reconstructive Surgery, Charing Cross University Hospital, London, England.
Plast Reconstr Surg. 1996 May;97(6):1200-6. doi: 10.1097/00006534-199605000-00015.
Capsular contracture consistently has been the most frequently noted complication of submuscular and subglandular breast augmentation. The etiology of this complication is still unknown, although silicone bleed, hematoma, infection, foreign bodies, and surgical trauma have been implicated. In this prospective, double-blind study, 61 women undergoing submuscular breast augmentation were randomized between Dow Corning textured and smooth-walled silicone gel implants. Any consequent capsular contracture was assessed by an independent plastic surgeon and also by the patients themselves. Objective evaluation was made by applanation tonometry. It was found that depending on doctors, patients, and objective method used, 3 to 9 percent grade III and IV encapsulation followed submuscular augmentation with textured implants and 10 to 20 percent with smooth-walled implants after 1 year. The differences were significant according to both patient assessment and applanation tonometry but not according to the physicians' evaluations. There was no correlation of capsular contracture with the age of the patient, duration of the operation, or degree of blood loss. There was a small but inconclusive difference in capsular contracture rate that favored the placement of textured rather than smooth implants in the submuscular pocket.
包膜挛缩一直是胸大肌下和乳腺下隆乳术最常被提及的并发症。尽管硅凝胶渗漏、血肿、感染、异物和手术创伤都被认为与此并发症有关，但其病因仍不清楚。在这项前瞻性双盲研究中，61例行胸大肌下隆乳术的女性被随机分为使用道康宁公司的表面有纹理和表面光滑的硅胶假体两组。任何随后发生的包膜挛缩由一名独立的整形外科医生以及患者本人进行评估。通过压平眼压测量法进行客观评估。结果发现，根据所采用的医生、患者及客观方法不同，术后1年时，使用表面有纹理假体行胸大肌下隆乳术后3%至9%出现Ⅲ级和Ⅳ级包膜挛缩，使用表面光滑假体的这一比例为10%至20%。根据患者评估和压平眼压测量法，差异均有统计学意义，但根据医生的评估则无差异。包膜挛缩与患者年龄、手术时间或失血量无关。在胸大肌下间隙植入表面有纹理而非表面光滑的假体时，包膜挛缩率存在微小但无定论的差异，前者似乎更具优势。
