Titanium-coated polypropylene mesh (TiLoop Bra®) - An effective prevention for capsular contracture?

被引：11

作者：

Bergmann P.A. ^{[1
]}

Becker B. ^{[2
]}

Mauss K.L. ^{[2
]}

Liodaki M.E. ^{[2
]}

Knobloch J. ^{[3
]}

Mailänder P. ^{[2
]}

Siemers F. ^{[1
]}

机构：

[1] Department for Plastic and Handsurgery/Burn Unit, Berufsgenossenschaftliche Kliniken Bergmannstrost, Halle (Saale)

[2] Plastic Surgery, Handsurgery, Burn Unit, Universityhospital Schleswig-Holstein, Lübeck, Lübeck

[3] Department for Microbiology, Universityhospital Schleswig-Holstein, Lübeck, Lübeck

来源：

European Journal of Plastic Surgery | 2014年 / 37卷 / 6期

关键词：

Breast augmentation; Capsular contracture; Oncoplastic breast surgery; Silicone implants; Titanium coating;

D O I：

10.1007/s00238-014-0947-3

中图分类号：

学科分类号：

摘要：

Background: Silicone implants have been used in breast augmentation for more than 45 years. Complications, in particular, capsular contracture, still occur with a high incidence. Titanium-coated polypropylene mesh (TCPM; TiLoop Bra®, pfm medical, Cologne, Germany) provides new opportunities for implant-based breast reconstruction. We investigated the influence of the surface of silicone implants on the formation of capsular contracture by comparing textured silicone with TCPM-covered smooth silicone implants. Methods: Twenty textured silicone gel-filled (group A) and twenty TCPM-covered smooth silicone gel implants (group B) (Silimed®, Rio de Janeiro, Brazil) were implanted in female Wistar rats. After 60 days, the implants and capsules were extracted, and histological and immunohistochemical staining was performed. The double-blind evaluation of the capsules was performed by two examiners. Results: We were able to detect a thinner, but stiffer, capsule and a less development of an inner synovia metaplasia layer as well as a lower vascularity in capsules around TCPM-covered silicone implants. We found a higher percentage of myofibroblasts within the capsule structure and more inflammatory cell infiltration. Conclusions: The quality of capsule structure around both tested implants differs significantly. Although capsules around TCPM-covered implants presented were thinner, they integrated with the mesh in a rigid cage structure capsule with higher infiltration of inflammatory cells caused by a significant foreign body reaction. TCPM-covered silicone implants showed no apparent advantage in the reduction of capsular contracture. On the other hand, the indication for using this material as a supportive soft tissue structure can be confirmed. Level of Evidence: not ratable, experimental study. © 2014 Springer-Verlag.

引用

页码：339 / 346

页数：7

共 41 条

[1]

Schaub T.A., Ahmad J., Rohrich R.J., Capsular contracture with breast implants in the cosmetic patient: Saline versus silicone - A systematic review of the literature, Plast Reconstr Surg, 126, 6, pp. 2140-2149, (2010)

[2]

Prantl L., Schreml S., Fichtner-Feigl S., Poppl N., Eisenmann-Klein M., Schwarze H., Fuchtmeier B., Clinical and morphological conditions in capsular contracture formed around silicone breast implants, Plastic and Reconstructive Surgery, 120, 1, pp. 275-284, (2007)

[3]

Gampper T.J., Khoury H., Gottlieb W., Morgan R.F., Silicone gel implants in breast augmentation and reconstruction, Annals of Plastic Surgery, 59, 5, pp. 581-590, (2007)

[4]

Wixtrom R.N., Stutman R.L., Burke R.M., Mahoney A.K., Codner M.A., Risk of breast implant bacterial contamination from endogenous breast flora, prevention with nipple shields, and implications for biofilm formation, Aesthet Surg J, 32, 8, pp. 956-963, (2012)

[5]

Moreno-Egea A., Carrillo-Alcaraz A., Soria-Aledo V., Randomized clinical trial of laparoscopic hernia repair comparing titanium-coated lightweight mesh and medium-weight composite mesh, Surg Endosc, (2012)

[6]

Jacombs A., Allan J., Hu H., Valente P.M., Wessels W.L., Deva A.K., Vickery K., Prevention of biofilm-induced capsular contracture with antibiotic-impregnated mesh in a porcine model, Aesthet Surg J, 32, 7, pp. 886-891, (2012)

[7]

Marques M., Brown S.A., Cordeiro N.D., Rodrigues-Pereira P., Cobrado M.L., Morales-Helguera A., Queiros L., Luis A., Freitas R., Goncalves-Rodrigues A., Amarante J., Effects of coagulase-negative staphylococci and fibrin on breast capsule formation in a rabbit model, Aesthet Surg J, 31, 4, pp. 420-428, (2011)

[8]

Tamboto H., Vickery K., Deva A.K., Subclinical (biofilm) infection causes capsular contracture in a porcine model following augmentation mammaplasty, Plast Reconstr Surg, 126, 3, pp. 835-842, (2010)

[9]

Del Pozo J.L., Tran N.V., Petty P.M., Johnson C.H., Walsh M.F., Bite U., Clay R.P., Mandrekar J.N., Piper K.E., Steckelberg J.M., Patel R., Pilot study of association of bacteria on breast implants with capsular contracture, J Clin Microbiol, 47, 5, pp. 1333-1337, (2009)

[10]

Mendes P.R.D.S., Bins-Ely J., Lima E.A.D.S., De Vasconcellos Z.A.A., D'Acampora A.J., Neves R.D., Histological study on acute inflammatory reaction to polyurethane-coated silicone implants in rats, Acta Cirurgica Brasileira, 23, 1, pp. 93-101, (2008)

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