Database : MEDLINE
Search on : Implant and Capsular and Contracture [Words]
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[PMID]: 29523044
[Au] Autor:Kim JB; Jeon HJ; Lee JW; Choi KY; Chung HY; Cho BC; Park SH; Park MH; Bae JS; Yang JD
[Ad] Address:a Departments of Plastic and Reconstructive Surgery, School of Medicine , Kyungpook National University , Daegu , Korea.
[Ti] Title:A murine model of radiation-induced capsule-tissue reactions around smooth silicone implants.
[So] Source:J Plast Surg Hand Surg;:1-8, 2018 Mar 09.
[Is] ISSN:2000-6764
[Cp] Country of publication:Sweden
[La] Language:eng
[Ab] Abstract:As the availability of breast reconstruction using implants is becoming widespread and many implant recipients undergo radiation therapy, there is an increasing interest in understanding the potential complications associated with capsule-tissue interactions in response to irradiation. Accordingly, our medical institution designed an animal experiment to investigate the effects of irradiation on capsular contracture. A total of 40 mice (C57BL6) were divided into four groups according to whether or not they received irradiation and the time from implantation to irradiation. After each mouse received a specially-fabricated, 1.5 cm semi-spherical silicone implant inserted into the area below the panniculus carnosus, half of the mice were irradiated using singe administration of a 10 Gy dose of radiation (6 MeV). Subsequently, data from gross inspection, histological analysis and immunohistochemical analysis were obtained at one and three months postoperatively and analyzed. Changes that occurred near the capsule led to the phenomenon of contracture subsequent to encapsulation. Our findings suggest that the inflammation reaction occurring near the implant becomes aggravated by 'radiation toxicity' and creates an environment conducive to capsular contracture. The present study demonstrated the process by which the complication of capsular contracture may occur during the treatment of human breast cancer via radiotherapy. These findings may serve as the basis for research and development of future treatments of capsular contracture.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher
[do] DOI:10.1080/2000656X.2018.1444617

  2 / 1094 MEDLINE  
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[PMID]: 29455110
[Au] Autor:Casella D; Di Taranto G; Marcasciano M; Sordi S; Kothari A; Kovacs T; Lo Torto F; Cigna E; Ribuffo D; Calabrese C
[Ad] Address:Department of Oncologic and Reconstructive Breast Surgery, "Breast Unit Integrata di Livorno, Cecina, Piombino, Elba, Azienda USL Toscana Nord Ovest", Italy.
[Ti] Title:Nipple-sparing bilateral prophylactic mastectomy and immediate reconstruction with TiLoop Bra mesh in BRCA1/2 mutation carriers: A prospective study of long-term and patient reported outcomes using the BREAST-Q.
[So] Source:Breast;39:8-13, 2018 Feb 18.
[Is] ISSN:1532-3080
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:BACKGROUND: Although demand for prophylactic mastectomy is increasing over time among women at a high risk for breast cancer, there is a paucity of studies on long term patient-reported outcomes after this procedure. METHODS: Between January 2011 and January 2015, 46 patients documented BRCA1/2 mutation carriers, eligible for prophylactic nipple-sparing mastectomy (NSM) and immediate breast prosthetic reconstruction were registered at our Institution. Patients underwent NSM and subcutaneous reconstruction with implant covered by a titanium-coated polypropylene mesh (TiLoop ). The BREAST-Q questionnaire was given to patients prior to surgery and at 1 and 2 years follow-up points. Capsular contracture was evaluated by Baker scale. Surgical outcomes along with the changes in BREAST-Q score were analyzed over time. RESULTS: Complications were reported in only one case and after two years the capsular contracture rates were acceptable (grade I: 65,2%; grade II: 32,6%; grade III 2,2%). At one year and two year follow-ups patients reported high rates in the measures of overall satisfaction with breasts (72,5 and 73,7 respectively), psychosocial well-being (78,4 and 78,6), sexual well-being (58,8 and 59,4), physical well-being (77,6 and 80,6) and overall satisfaction with outcome (75,7 and 79,7). A statistically significant increase in all BREAST-domains from the preoperative to the postoperative period was reported at one and two years follow-ups (p < 0,05). CONCLUSION: Following bilateral prophylactic NSM and immediate subcutaneous reconstruction with TiLoop , patients demonstrated high levels of satisfaction and quality of life as measured by BREAST-Q. 2-years outcomes confirmed high patient comfort with increased scores from the preoperative baseline level.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher

  3 / 1094 MEDLINE  
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[PMID]: 29378017
[Au] Autor:Barnea Y; Hammond DC; Geffen Y; Navon-Venezia S; Goldberg K
[Ad] Address:Dr Barnea is Head of the Plastic and Reconstructive Breast Surgery Unit, Department of Plastic Surgery, Tel-Aviv Sourasky Medical Center, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
[Ti] Title:Plasma Activation of a Breast Implant Shell in Conjunction With Antibacterial Irrigants Enhances Antibacterial Activity.
[So] Source:Aesthet Surg J;, 2018 Jan 25.
[Is] ISSN:1527-330X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Background: Infection and capsular contracture are two of the most significant complications of breast-implant surgery. Both complications are associated with bacterial contamination of the implant surface. Plasma activation of the surface of a silicone breast implant changes its surface properties from water repelling (hydrophobic) to water absorbing (hydrophilic), thus making it possible for antibacterial irrigants to temporarily adsorb onto the implant surface. Objective: To support our hypothesis that by changing the surface properties we could render antibacterial irrigation more effective in inhibiting bacterial growth on a breast implant shell. Methods: An in-vitro study using silicone discs cut from a textured silicone breast implant shell was performed by treating some of the discs with plasma activation and then exposing the discs to contamination with either Staphylococcus aureus or Pseudomonas aeruginosa and then variously treating the discs with 10% povidone iodine, Cefazolin, or Gentamicin. Bacterial contamination was verified and counted using contact plates as well as culture media. Results: Plasma activation changed the wetting properties of the disc's surface from hydrophobic to hydrophilic. Non-plasma activated contaminated discs demonstrated clear bacterial growth both in the untreated group and in the antibacterial-treated group. Combining antibacterial treatment with plasma activation resulted in complete inhibition of bacterial growth in each of the groups treated with antibacterial irrigants. Conclusions: Combining plasma activation with topical antibacterial irrigants can inhibit the growth of bacteria on implant shell discs. By changing the properties of the surface from hydrophobic to hydrophilic, the adsorption of the antibacterial irrigants is enhanced.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1093/asj/sjy020

  4 / 1094 MEDLINE  
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[PMID]: 29365064
[Au] Autor:Gabriel A; Sigalove S; Sigalove NM; Storm-Dickerson TL; Rice J; Pope N; Patrick Maxwell G
[Ad] Address:Department of Plastic Surgery, Loma Linda University Medical Center, Loma Linda, CA.
[Ti] Title:Prepectoral Revision Breast Reconstruction for Treatment of Implant-Associated Animation Deformity: A Review of 102 Reconstructions.
[So] Source:Aesthet Surg J;, 2018 Jan 20.
[Is] ISSN:1527-330X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Background: Animation deformity is a direct consequence of subpectoral implant placement for breast reconstruction following mastectomy. Current treatment options ameliorate but do not address the source of the problem. Moving the implant from subpectoral to prepectoral has the potential to eliminate animation deformity. Objectives: Describe the technique and outcomes of prepectoral revision reconstruction in over 100 cases and discuss patient selection criteria for a successful outcome. Methods: Patients who presented with animation deformity following two-stage implant reconstruction were included in this retrospective study. Revision surgery involved removal of the existing implant via the previous incision site along the inframammary fold, suturing of the pectoralis major muscle back to the chest wall, creation of a prepectoral pocket for the new implant, use of acellular dermal matrix to reinforce the prepectoral pocket and completely cover the implant, and fat grafting to enhance soft tissue. Patients were evaluated for resolution of animation deformity and occurrence of complications during follow up. Results: Fifty-seven patients (102 breasts) underwent prepectoral revision reconstruction with complete resolution of animation deformity. Complications occurred in 4 breasts (3.9%) and included seroma (2 breasts), skin necrosis (3 breasts), and wound dehiscence (1 breast). All 4 breasts with complications had their implants removed and replaced. There were no incidences of infection or clinically significant capsular contracture in this series. Conclusions: Revision reconstruction with prepectoral implant placement and complete coverage with acellular dermal matrix resolves animation deformity and results in aesthetically pleasing soft breasts. Patient selection is critical for the success of this technique.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1093/asj/sjx261

  5 / 1094 MEDLINE  
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[PMID]: 29190321
[Au] Autor:Hu H; Sleiman J; Johani K; Vickery K
[Ad] Address:Surgical Infection Research Group, Faculty of Medicine and Health Sciences, Macquarie University, NSW, Australia.
[Ti] Title:Hypochlorous Acid Versus Povidone-Iodine Containing Irrigants: Which Antiseptic is More Effective for Breast Implant Pocket Irrigation?
[So] Source:Aesthet Surg J;, 2017 Nov 28.
[Is] ISSN:1527-330X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Background: Capsular contracture induced by chronic subclinical infection is a major cause of poor outcomes and reoperation in breast implant surgery. The use of pocket irrigation with antiseptic/antibiotic has been shown to reduce the incidence of contracture. A new formulation of hypochlorous acid solution PhaseOne has been proposed as potential agent for irrigation. Objectives: This study aimed to test the efficacy of hypochlorous acid solution PhaseOne for use in breast pocket irrigation as an alternative to povidone iodine solution Betadine. Methods: The efficacy of PhaseOne, a hypochlorous acid formulated wound and skin cleanser, was tested in vitro against planktonic and biofilm Staphylococcus aureus with or without biological soil and in an implant attachment assay. Its activity was compared with Betadine containing 10% povidone iodine. Results: Our findings showed that PhaseOne was unable to eradicate planktonic and/or biofilm S. aureus in the presence of either tryptone soy broth or bovine calf serum (protein soil) in a variety of in vitro assays. Conclusions: We advise that povidone iodine containing irrigants are superior to hypochlorous acid containing irrigants in the clinical setting and should remain the recommended solution for pocket irrigation to reduce bacterial contamination at breast implants surgery.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1093/asj/sjx213

  6 / 1094 MEDLINE  
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[PMID]: 29506340
[Au] Autor:Kim L; Castel N; Parsa FD
[Ad] Address:Division of Plastic Surgery, Department of Surgery, University of Hawaii, John A. Burns School of Medicine, Honolulu, HI, USA.
[Ti] Title:Case of late hematoma after breast augmentation.
[So] Source:Arch Plast Surg;, 2018 Mar 05.
[Is] ISSN:2234-6163
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:We present a case report of a patient who experienced a late, spontaneous breast hematoma 26 years after primary breast augmentation. Late hematomas are a rare complication of breast augmentation with uncertain etiology. In this case, there was no trauma, calcifications, or implant rupture. We believe the patient's hematoma was secondary to erosion of a capsular vessel due to capsular contracture.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher
[do] DOI:10.5999/aps.2016.01718

  7 / 1094 MEDLINE  
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[PMID]: 29506328
[Au] Autor:Park SH; Sim HB
[Ad] Address:Department of Plastic and Reconstructive Surgery, Soonchunhyang University Hospital, Seoul, Korea.
[Ti] Title:Endoscopic transaxillary prepectoral conversion for submuscular breast implants.
[So] Source:Arch Plast Surg;, 2018 Mar 05.
[Is] ISSN:2234-6163
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:Background: During breast augmentation, the transaxillary approach provides the advantage of allowing the mammary prosthesis to be placed through incisions that are remote from the breast itself, thereby reducing the visibility of postoperative scars. For patients experiencing capsular contracture who do not want additional scars, the previous transaxillary scar can be used for site change and implant exchange. Methods: This study analyzed 17 patients (34 breasts) with submuscular breast implants with grade III-IV capsular contracture who received treatment from 2010 to 2015. The mean age of the patients was 29 years (range, 20-38 years). The inclusion criterion was a pinch test of more than 3 cm at the upper pole of the breast. Previous axillary scars were used to expose the pectoralis fascia, and submuscular breast implants were removed carefully. The dissection underneath the pectoralis fascia was performed with endoscopic assistance, using electrocautery under direct visualization. Results: The mean follow-up period was 14 months (range, 6-24 months). The entire dissection plane was changed from the submuscular plane to the subfascial plane. Round textured gel implants were used, with a mean implant size of 220 mL (range, 160-300 mL). Two patients developed grade II capsular contracture. There were no cases of malposition or asymmetry. Three patients complained of minor implant palpability. None of the patients required additional surgery. Conclusions: Endoscopic subfascial conversion may be an effective technique for treating capsular contracture and avoiding scarring of the breast in selected patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher
[do] DOI:10.5999/aps.2017.01263

  8 / 1094 MEDLINE  
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[PMID]: 29420643
[Au] Autor:Cappellano G; Ploner C; Lobenwein S; Sopper S; Hoertnagl P; Mayerl C; Wick N; Pierer G; Wick G; Wolfram D
[Ad] Address:Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, Innsbruck, Austria.
[Ti] Title:Immunophenotypic characterization of human T cells after in vitro exposure to different silicone breast implant surfaces.
[So] Source:PLoS One;13(2):e0192108, 2018.
[Is] ISSN:1932-6203
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The most common complication of silicone breast implants is capsular contracture (massive scar formation around the implant). We postulate that capsular contracture is always a sequel to inflammatory processes, with both innate and adaptive immune mechanisms participating. In general, fibroblasts and macrophages have been used as cell types to evaluate in vitro the biocompatibility of breast implant surfaces. Moreover, also T cells have been found at the implant site at the initial stage of fibrous capsule formation. However, only few studies have addressed the influence of surfaces with different textures on T-cell responses. The aim of the present study was to investigate the immune response of human peripheral blood mononuclear cells (PBMC) to commercially available silicone breast implants in vitro. PBMC from healthy female blood donors were cultured on each silicone surface for 4 days. Proliferation and phenotype of cultured cells were assessed by flow cytometry. Cytokine levels were determined by multiplex and real-time assay. We found that silicone surfaces do not induce T-cell proliferation, nor do they extensively alter the proportion of T cell subsets (CD4, CD8, naïve, effector memory). Interestingly, cytokine profiling identified matrix specific differences, especially for IL-6 and TNF-α on certain surface topographies that could lead to increased fibrosis.
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1802
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:In-Process
[do] DOI:10.1371/journal.pone.0192108

  9 / 1094 MEDLINE  
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[PMID]: 29481480
[Au] Autor:Lin AJ; Karinja SJ; Bernstein JL; Jin J; Toyoda Y; Miller AJ; Zanzonico PB; Spector JA
[Ti] Title:In Search of a Murine Model of Radiation-Induced Periprosthetic Capsular Fibrosis.
[So] Source:Ann Plast Surg;, 2018 Feb 23.
[Is] ISSN:1536-3708
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Capsular contracture after breast reconstruction is a morbid complication, occurring in 30.0% to 47.5% of patients undergoing postoperative radiotherapy. Although it is well known that radiation increases rate of capsular contracture, there are few well-established animal models that faithfully replicate standard-of-care clinical practice, that is, prosthesis placement at the time of mastectomy followed by delayed radiotherapy. To better recapitulate current clinical practice, we developed a murine model in which the implant sites were irradiated 10 days postoperatively, rather than at time of surgery. METHODS: Hemispherical implants were created from polydimethylsiloxane and implanted bilaterally in the subcutaneous dorsa of 20 C57Bl/6 mice. Mice were randomized to 5 treatment groups, differing in irradiation dose: 0 to 40 Gy. Ten days postoperatively, irradiation was performed using 250-kVp x-rays (XRAD225Cx, Precision X-ray, North Branford, Conn). In 1 mouse per group, dosimeters were placed subcutaneously to measure the delivered absorbed dose. Thirty-one days postoperatively, the mice were sacrificed and examined grossly, and periprosthetic tissues were removed for histologic analysis of periprosthetic capsule thickness and cellular deposition. RESULTS: Total radiation dose was calculated by the treatment planning software and confirmed by the in vivo dosimeters. Physical examination of the irradiated region demonstrated evidence of local radiation delivery, including circular patterns of hair blanching and thinning directly over the implants. Furthermore, histologic analysis of the irradiated epidermis demonstrated dose-dependent radiation changes including keratin whorls and patches of uneven epidermal thickness. There was no statistically significant difference in capsule thickness among the groups. Mice in the 30 and 40 Gy groups endured complications including shortness of breath, coagulopathy, and death, signs of systemic radiation poisoning. CONCLUSIONS: There was no evidence of increased periprosthetic capsule thickness with localized irradiation, irrespective of dose up to 20 Gy. These results differ from those previously published, which demonstrated increased capsule thickness with 10 Gy irradiation. Given the evidence of local radiation delivery, we believe that the lack of increase in capsule thickness observed in our experiment is a real phenomenon and demonstrate the difficulty in creating an easily reproducible rodent model that mimics the effects of postmastectomy implant-based reconstruction and irradiation.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180226
[Lr] Last revision date:180226
[St] Status:Publisher
[do] DOI:10.1097/SAP.0000000000001362

  10 / 1094 MEDLINE  
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[PMID]: 29481475
[Au] Autor:Campbell CA
[Ad] Address:From the Department of Plastic Surgery, University of Virginia Health System, Charlottesville, VA.
[Ti] Title:The Role of Triple-Antibiotic Saline Irrigation in Breast Implant Surgery.
[So] Source:Ann Plast Surg;, 2018 Feb 23.
[Is] ISSN:1536-3708
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Implant-based breast reconstruction accounts for more than 70% of all breast reconstructions, and breast augmentation is the most commonly performed cosmetic operation annually. The clinically significant impact of infection and capsular contracture after breast implant surgery has brought clinicians to create infection reduction protocols for both oncologic and cosmetic operations alike. The use of triple-antibiotic saline irrigation has become a recommended intraoperative maneuver within these protocols to minimize surgical site infections, but the constituents of the irrigation, its individual efficacy, and the acceptability of including povidone-iodine within irrigation recipes have been debated. This review will investigate the microbiological data behind the selection of the constituents of triple-antibiotic saline. In vitro testing of the effectiveness of topical antibiotics used in saline irrigation against microorganisms responsible for breast implant infection is reviewed. Clinical data are presented describing the impact of triple-antibiotic saline on implant infection and capsular contracture after cosmetic and reconstructive surgery.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180226
[Lr] Last revision date:180226
[St] Status:Publisher
[do] DOI:10.1097/SAP.0000000000001345


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