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1.
Acta Chir Plast ; 63(3): 127-138, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34814694

RESUMO

BACKGROUND: Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a recently discovered malignancy of T-cell type, correlated with the use of silicone breast implants. It has been theorized that the etiology may be linked to bacterial growth and long-term inflammation. The afflicted patient usually presents with breast swelling due to peri-implant fluid accumulation. Currently, the diagnosis is achieved by ultrasound, biopsy and testing for certain biomarkers. Following this, the treatment is achieved by complete surgical excision, or by capsulectomy and exchange with smoother surfaced implants. The aim of this study was to identify and report 50 most cited articles related to the field of BIA--ALCL. METHODS: The Web of Science Citation Index was used to identify 325 articles pertaining to BIA-ALCL. The 50 most cited articles among these were included in this study. The title, author name, journal and year of publication, country and institute of origin, level of evidence (LoE), type of study (clinical or basic), and topic of study (pathophysiology, oncologic management, diagnosis, case report and case series) were recorded. RESULTS: This study includes articles from the period 1997-2018 with an average citation rate of 65.5. The majority of the top cited articles (36%; N = 18) were found to be case reports, followed by case series (18%; N = 9), systemic reviews (12%; N = 6) and studies focused on the pathophysiology (16%; N = 8), oncologic management (6%; N = 3), databases (6%; N = 3), diagnostics (4%; N = 2) and informed consent (2%; N = 1). The articles were published across 30 journals and originated from 35 institutes. The United States was found to be the country of origin of most of the studies. While none of the articles achieved LoE 1, many were found to have LoE 4 (N = 11) or 5 (N = 19). Most of the articles (N = 42), were clinical research studies. CONCLUSION: According to this citation analysis, a large fraction of the existing high impact literature on BIA-ALCL is focused on disease monitoring. Through this study, we hope to present a simple educational tool to better appreciate the research in this relatively young field.


Assuntos
Implantes de Mama , Neoplasias da Mama , Linfoma Anaplásico de Células Grandes , Implantes de Mama/efeitos adversos , Neoplasias da Mama/etiologia , Feminino , Humanos , Linfoma Anaplásico de Células Grandes/etiologia
2.
Anticancer Res ; 41(11): 5365-5375, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34732406

RESUMO

Reconstructive breast surgery following total or partial mastectomy can be performed using autologous tissues or breast implants, and each has its own set of complications. Most women do not experience significant complications and are highly satisfied but breast reconstruction must consider potential complications from surgical techniques, as well as additional complications that may arise from oncological treatment modalities such as radiation therapy and chemotherapy. The aim of this article is to provide a systemic overview of possible complications that may arise in the course of reconstructive breast surgery. Complications associated with flap-based or implant-based breast reconstruction can be classified as: i) Complications inherent to surgery and common to all, including seroma, bleeding, and hematoma; skin necrosis; and infection, among others. ii) Complications specifically related to reconstruction, such as flap ischemia/necrosis/loss; fat necrosis; implant capsular contracture; implant failure, exposure, or malposition. In conclusion, this overview of possible complications is intended to improve the decision-making process when considering breast reconstruction.


Assuntos
Implante Mamário/efeitos adversos , Implantes de Mama/efeitos adversos , Mamoplastia/efeitos adversos , Mastectomia , Complicações Pós-Operatórias/etiologia , Implante Mamário/instrumentação , Tomada de Decisão Clínica , Feminino , Humanos , Mamoplastia/instrumentação , Mastectomia/efeitos adversos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/terapia , Desenho de Prótese , Qualidade de Vida , Medição de Risco , Fatores de Risco , Resultado do Tratamento
3.
Surg Infect (Larchmt) ; 22(9): 968-972, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34723647

RESUMO

Background: Breast implant placement is a common operation performed by plastic surgeons, with more than 78,664 implant-based breast reconstructions carried out in the United States in 2016. Infection is a major concern for the reconstructive surgeon, with rates estimated at 2%-4% for implant exchanges. Use of peri-operative antibiotics is variable and provider dependent and is not without risk. Methods: Charts for all women undergoing mastectomy and immediate reconstruction at our institution from July 1, 2011-January 1, 2020 by a single plastic surgeon were reviewed. Patient characteristics, operative technique, and history of radiation, chemotherapy, hormonal treatment, and antibiotic protocols were collected for each patient. The data were analyzed using χ2 and Student t-tests. Results: Chart review was performed for 234 consecutive patients undergoing exchange of breast implants. Patients received only a single dose of peri-operative antibiotics before the first incision without post-operative antibiotics. In these patients, a total of 407 implant exchanges occurred. Post-operative cellulitis was found in 13 instances in 12 patients (infection rate of 3.1%) and was treated successfully with oral antibiotics in 11 of 13 cases. Two patients required operative washout (0.04%). Most of the infections (69%) were found on the side of the cancer. Patients experiencing post-operative infections were more likely to have had adjuvant chemotherapy (p = 0.007) than patients without infection. There was no significant difference between the two groups with regard to neo-adjuvant chemotherapy, radiation to the affected breast, or hormonal therapy or in terms of age, Body Mass Index, or the presence of diabetes mellitus. Intra-operative povidone-iodine (Betadine) swabbing and antibiotic selection did not have an impact on infection risk. Conclusions: A single dose of antibiotics results in sufficiently low rates of infection in patients undergoing breast implant exchange. Adjuvant chemotherapy is a clinically significant risk factor for infection in these patients.


Assuntos
Implantes de Mama , Neoplasias da Mama , Mamoplastia , Antibacterianos/uso terapêutico , Implantes de Mama/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/cirurgia , Feminino , Humanos , Mastectomia , Estudos Retrospectivos , Fatores de Risco
4.
Ann Ital Chir ; 92: 505-508, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34795110

RESUMO

AIM: Breast implant-associated anaplastic large cell lymphoma, is a rare cancer. Several theories are speculated that may constitute its etiological factors. None of them has been clearly proven. The case report we present is intended to indicate the leading cause of this disease entity. CASE PRESENTATION: Air samples taken in varying conditions at appropriate intervals by the MicroFlow Alfa 90 device in the operating room during five breast implant surgery were analyzed. Samples were taken four times during each operation. After the air was taken and delivered to the laboratory, the plates were immediately incubated under aerobic conditions. The incubation was carried out for up to 7 days. It has been shown that there is a significant difference between the total number of microorganisms during air intake carried out without and with the supply of air to purify the area in a given area by air recirculation of the operating block and cleaning it from bacteria and particles. No air colony-forming units were grown from air samples taken in the supply. However, from air samples taken without blowing, they were raised in various quantities. CONCLUSION: Laminar free airflow used in operating room conditions significantly reduces the risk of infection of the surgical site, and thus may reduce the risk of developing breast implant-associated anaplastic large cell lymphoma. KEY WORDS: BIA-ALCL ethiological factors, Biofilm, Breast implants, Laminar air flow, Surgical site infections.


Assuntos
Implante Mamário , Implantes de Mama , Neoplasias da Mama , Linfoma Anaplásico de Células Grandes , Biofilmes , Implantes de Mama/efeitos adversos , Neoplasias da Mama/etiologia , Neoplasias da Mama/cirurgia , Feminino , Humanos , Linfoma Anaplásico de Células Grandes/epidemiologia , Linfoma Anaplásico de Células Grandes/etiologia , Linfoma Anaplásico de Células Grandes/cirurgia , Salas Cirúrgicas
5.
BMJ Case Rep ; 14(9)2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34497056

RESUMO

Our patient was a 57-year-old woman with a history of bilateral retropectoral silicone breast augmentation and axillary hyperhidrosis who underwent a bilateral thoracic sympathectomy via video-assisted thoracoscopic surgery by a surgeon at an outside hospital approximately 20 years ago. The left side required an open thoracotomy. Shortly after the surgery, she developed a left-sided Baker 4 capsular contracture and the left implant was noted to be ruptured. Both implants were exchanged. Several years later the patient began to experience progressive fatigue. Work-up revealed a left lung nodule and she underwent a biopsy that confirmed silicone granulomas. It was hypothesised that at the time of her initial thoracotomy the implant was violated resulting in silicone spillage into the thoracic cavity. The patient was referred to our institution for advanced management of her intrathoracic silicosis. The patient underwent bilateral removal of her silicone implants, total capsulectomy and needle-localised removal of her left thoracic silicone masses. She had an uneventful postoperative course with resolution of her fatigue.


Assuntos
Implante Mamário , Implantes de Mama , Mamoplastia , Implantes de Mama/efeitos adversos , Feminino , Humanos , Doença Iatrogênica , Pessoa de Meia-Idade , Géis de Silicone/efeitos adversos
6.
Ann Plast Surg ; 87(4): 396-401, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34559710

RESUMO

BACKGROUND: Despite best practices, infection remains the most common complication after breast reconstruction with expanders and implants, ranging from 2% to 29%. Empiric broad-spectrum antibiotics are frequently used in nonsurgical treatment of implant-associated infections in an effort to salvage the reconstruction. Pitfalls of antibiotherapy include adverse events, vascular access site complications, and drug resistance. Our goals were to describe management of implant infections with broad-spectrum antibiotics, review treatment related adverse events, and report on outcomes of therapy. PATIENTS AND METHODS: A retrospective review was carried out to identify patients who were treated with intravenous (IV) antibiotics for periprosthetic infection. Patient characteristics, surgical details, and antibiotic therapy-related adverse events were collected. Eventual outcome related to expander/implant salvage was noted. RESULTS: A total of 101 patients (111 treatment episodes) were identified. Mean duration of antibiotic treatment was 18 days (range, 1-40 days). The most commonly used parenteral treatment was a combination of daptomycin with piperacillin-tazobactam (65%) or an alternative agent (16%). Fifty-nine percent of treatment episodes resulted in salvage of the expander or implant. Thirty-five percent treatment episodes were associated with 1 or more adverse events: diarrhea (12.6%), rash (10%), vaginal candidiasis (3.6%), agranulocytosis/neutropenic fever (3.6%), nausea (3.6%), urinary complaint (0.9%), myositis (0.9%), headache (0.9%), vascular line occlusion (1.8%), deep vein thrombosis (1.8%), and finger numbness (0.9%). No patients developed Clostridium difficile colitis. Five episodes (4%) needed discontinuation of antibiotics because of severe adverse events. The prosthesis was explanted in 3 of the cases of discontinued treatment. CONCLUSIONS: Our findings show favorable outcomes and well-tolerated adverse effects with broad-spectrum parenteral antibiotherapy for periprosthetic infection. However, every effort should be made to deescalate therapy by narrowing the spectrum or limiting the duration, to minimize adverse events and development of bacterial resistance. Treating surgeons need to carefully weigh benefits of therapy and be aware of potential complications that might necessitate discontinuation of treatment.


Assuntos
Implante Mamário , Implantes de Mama , Infecções Relacionadas à Prótese , Antibacterianos/efeitos adversos , Implante Mamário/efeitos adversos , Implantes de Mama/efeitos adversos , Feminino , Humanos , Infecções Relacionadas à Prótese/tratamento farmacológico , Estudos Retrospectivos
7.
Biomed Res Int ; 2021: 3898585, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34337008

RESUMO

Purpose: Capsular formation around breast implants can produce various complications, including erythema, tenderness, discomfort, and breast deformation. Moreover, the capsule is thought to be correlated with breast implant-associated anaplastic large cell lymphoma. The proposed technique of capsule reduction can prevent some of these complications. Thus, the authors suggest a no-touch technique in two-stage, implant-based breast reconstruction. Patients and Methods. This single-center retrospective study evaluated the medical records and digitalized pathological slides of patients who underwent two-stage, implant-based breast reconstruction between February 2018 and May 2019. The selected patients were divided into group A and group B. Group A underwent a no-touch technique that included the following two steps: (1) using a sizer as the frame to create the submuscular and acellular dermal matrix (ADM) pocket for expander insertion and (2) inserting the expander through the funnel. After the second stage of implant insertion, the capsule was harvested for biopsy of the ADM, chest wall, and muscle. Results: This study included 33 breasts (31 patients): 18 in group A and 15 in group B. The capsular thicknesses of the ADM, the chest wall, and the muscle of group A were significantly thinner than those in group B. Pearson's correlation coefficient indicated negative correlations between capsular thickness and age; underlying disease; lesion side; interval of two-stage implant insertion; size of the expander; and radiotherapy, chemotherapy, or hormone therapy. Conclusion: To reduce the incidence of capsular formation following breast reconstruction using prostheses, a no-touch technique that uses a funnel and sizer to avoid implant contact is both efficient and beneficial.


Assuntos
Implantes de Mama/efeitos adversos , Mamoplastia/efeitos adversos , Adulto , Biópsia , Mama/patologia , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Dispositivos para Expansão de Tecidos
8.
In Vivo ; 35(5): 2739-2746, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34410963

RESUMO

AIM: This research compares postoperative complication rates with Strattice™, SERAGYN® BR, and TiLOOP® Bra interposition devices for subpectoral implant placement after skin or nipple sparing mastectomy. PATIENTS AND METHODS: 188 breast reconstructions in 157 patients after primary (n=96), secondary (n=71), or prophylactic (n=21) surgery were analyzed regarding major and minor complications. RESULTS: With acellular dermal matrix (ADM) Strattice™, 27.5% major and 27.5% minor complications occurred. Implant loss rates were 27.3% in primary and 30.8% in secondary reconstructions. With SERAGYN® BR, 11.1% major and 13,0% minor complications occurred. Implant losses (6.1%) occurred exclusively in primary reconstructions. With TiLOOP® Bra, 14.9% major and 9.6% minor complications occurred. Implant loss rates were 7.7% in primary and 7.1% in secondary reconstructions. CONCLUSION: ADM was associated with high complication rates in primary and secondary reconstructions. Low complication rates were seen with mesh interposition devices in primary, secondary, and prophylactic reconstructions.


Assuntos
Derme Acelular , Implante Mamário , Implantes de Mama , Neoplasias da Mama , Mamoplastia , Animais , Implante Mamário/efeitos adversos , Implantes de Mama/efeitos adversos , Neoplasias da Mama/cirurgia , Feminino , Humanos , Mamoplastia/efeitos adversos , Mastectomia/efeitos adversos , Polipropilenos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Suínos
9.
Plast Surg Nurs ; 41(3): 150-153, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34463305

RESUMO

I am one of only a few patients who have undergone reimplantation with breast implants directly after a diagnosis of breast implant associated-anaplastic large cell lymphoma (BIA-ALCL). This decision was a very personal one and many may question why I would make such a rash decision so soon after being diagnosed. I am proof that this new type of man-made cancer, unknown until the mid-to-late 90s or early 2000s, developed as a result of textured breast implants. The objective of this article is to bring awareness to health care professionals about BIA-ALCL, provide a brief history of the United States Food and Drug Administration textured breast implant approvals and subsequent recall, and talk about the emotional rollercoaster this diagnosis brings to the patient.


Assuntos
Implantes de Mama/efeitos adversos , Linfoma Anaplásico de Células Grandes/etiologia , Linfoma Anaplásico de Células Grandes/psicologia , Feminino , Humanos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/psicologia , Estigma Social
10.
J Clin Ultrasound ; 49(9): 984-986, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34405902

RESUMO

Fluid collection surrounding breast implants, called seroma, is a frequent issue that has diverse etiologies. We describe a 48-year-old woman with an acute onset of bilateral breast swelling occurring 5 years after aesthetic surgery and 10 days after a second SARS-CoV-2 mRNA vaccine dose. At breast ultrasound, we found an abundant bilateral peri-implant seroma. Our patient noticed symptom improvement 48 h after nonsteroidal anti-inflammatory drug treatment, complete disappearance of symptoms after 10 days with seroma disappearance documented by ultrasound. We hypothesized a breast implant seroma as post-SARS-CoV-2 mRNA vaccine side effect, as different other diagnosis had been excluded.


Assuntos
Implantes de Mama , COVID-19 , Implantes de Mama/efeitos adversos , Vacinas contra COVID-19 , Feminino , Humanos , Pessoa de Meia-Idade , RNA Mensageiro , SARS-CoV-2 , Seroma/diagnóstico por imagem , Seroma/etiologia
12.
Ann Plast Surg ; 87(2): 211-221, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34253702

RESUMO

ABSTRACT: Modern breast surgery was first introduced in the United States in 1962 with the use of silicone gel-filled breast implants. Over the past 6 decades, development of breast implants has been challenged by a variety of influencers including aesthetic appeal in shape, texture, and material; challenges in managing outcomes such as contracture, disease, and rupture; and public perception of risks associated with implants. In 1992, silicone breast prostheses were banned by the US Food and Drug Administration with exception for use in breast reconstruction, congenital deformities, or to replace existing implants.The ban led to heightened concerns about implants and possible disease manifestations. Knowledge of the historical evolution of breast prostheses is useful for understanding the associated risks and outcomes unique to each breast implant era. This article aimed to explore characteristics of breast implants by generation, with implications for diagnosis and assistance to modern surgical planning for novice plastic surgeons.


Assuntos
Implante Mamário , Implantes de Mama , Mamoplastia , Implante Mamário/efeitos adversos , Implantes de Mama/efeitos adversos , Humanos , Mastectomia , Géis de Silicone/efeitos adversos , Estados Unidos
16.
Ann Chir Plast Esthet ; 66(4): 338-340, 2021 Aug.
Artigo em Francês | MEDLINE | ID: mdl-34303485

RESUMO

Breast implant infection is a potential complication after surgery. This case reports an unusual infection. A patient undergoes a skin sparing mastectomy for a carcinoma with an immediate breast implant reconstruction. Few days after, she consults for pain, erythema and fluctuating breast collection. The implant is removed and a lavage is done. Bacteriological cultures yield Pasteurella Multocida. She has close contact with cats. Her cat scratches a drain. It looks crucial to educate patients before they go back home. Correct postoperative cares and avoid pets are important to prevent complications.


Assuntos
Implantes de Mama , Neoplasias da Mama , Mamoplastia , Infecções por Pasteurella , Pasteurella multocida , Animais , Implantes de Mama/efeitos adversos , Gatos , Feminino , Humanos , Mastectomia
17.
J Plast Reconstr Aesthet Surg ; 74(11): 2831-2845, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34257035

RESUMO

BACKGROUND: The current management of an infected breast implant is varied. This systematic review and meta-analysis aim to synthesise the current evidence and establish the efficacy of the various managements of infected breast implants. METHODS: A comprehensive search in the MEDLINE, EMBASE and CENTRAL databases was conducted for primary clinical studies that report on the management of infected breast implants from 1946 to September 2019. The primary outcome measure was the proportion of patients with successful treatment. RESULTS: Nineteen articles that involve 1044 patients were included. Overall, 29.00% (95% CI = from 11.51% to 50.58%) of the patients with mild infection were treated exclusively with antibiotics, of which, 81.41% (95% CI = from 57.82% to 96.63%) were successfully treated without the need for surgical intervention. Another 39.01% (95% CI = from 21.41% to 58.23%) of the patients underwent surgical salvage of the infected breast implants, of which 84.56% (95% CI = from 74.92% to 92.20%) successfully retained the salvaged implants without infection recurrence. Meanwhile, 35.01% (95% CI = from 27.01% to 43.57%) of the patients underwent explantation of the infected breast implant, of which, only 39.02% (95% CI = from 23.93% to 55.28%) had re-insertion of a new implant on a later date and 4.99% (95% CI = from 1.66% to 9.99%) of these patients had recurrence of infection requiring removal of the infected implant. The commonest complication was capsular contracture, which was reported in 10.78% (95% CI = from 4.41% to 19.49%) of the patients. Changes in the quality of life and cost implications were not reported. CONCLUSION: This study consolidates current available evidence on the management of infected breast implants, which could assist decision-making and improve patient education; however, current data are limited because of the lack of level-1 evidence.


Assuntos
Implantes de Mama/efeitos adversos , Mamoplastia/efeitos adversos , Infecções Relacionadas à Prótese/terapia , Antibacterianos/uso terapêutico , Remoção de Dispositivo , Estética , Feminino , Humanos , Contratura Capsular em Implantes/etiologia , Reoperação
18.
Breast ; 59: 76-78, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34174765

RESUMO

Besides reports of alarming potential side effects after COVID-19 vaccinations there have been rare observations of rather benign reactions to foreign materials such as cosmetic hyaluronic acid filler injections after a COVID-19 immunization. Likewise to dermal fillers any foreign material may cause a reaction when the immune system is triggered. In the recent weeks we observed four noteworthy potential reactions in association with breast implants between one and three days after COVID-19 vaccinations. We release these information at the earliest to educate colleagues and draw attention to possible reactions between the COVID-19 vaccines and foreign bodies such as breast implants.


Assuntos
Implantes de Mama/efeitos adversos , Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , Preenchedores Dérmicos , Imunidade , Idoso , Neoplasias da Mama , Vacinas contra COVID-19/efeitos adversos , Preenchedores Dérmicos/administração & dosagem , Feminino , Fibrose , Humanos , Pessoa de Meia-Idade , Dor , SARS-CoV-2 , Vacinação/efeitos adversos
19.
Medicina (Kaunas) ; 57(5)2021 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-34063687

RESUMO

Background and Objective: Breast implant surgery for cosmetic purposes is the most popular plastic surgery and it has been performed for over 100 years. Rupture of silicone gel-filled breast implants usually is asymptomatic and is one of the more dangerous complications due to free silicone migration. The aim of our study was to evaluate the diagnostic value of ultrasound (US) in the evaluation of the integrity of silicone breast implants and identify the main sign of intact and ruptured breast implants. Patients and Methods: In this retrospective study, the medical documentation of women who underwent breast implant surgery and US checkups at Tautrimas Astrauskas Clinic in Kaunas, Lithuania, during 2015-2020 was analyzed. The patients were divided into two groups: patients with intact and ruptured breast implants. The accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) as well as the signs of implant integrity of US examination were evaluated. Results: In this study, 76 women with bilateral breast implants (n = 152) were reviewed. On a US examination, ruptured implants were found in 41.1% (n = 61) of the cases; of them, 78.7% (n = 48) of the cases had ≥2 US signs of a ruptured implant, and in all these cases, implant rupture was confirmed at surgery. Overall, one US sign of a ruptured implant was found in 21.3% (n = 13) of the cases. Of them, inhomogeneous content in all cases (n = 3) was found in the intact implant group, and an abnormal implant shell was documented more often in the ruptured implant group, not intact one (n = 9, 90% vs. n = 1, 10%). US had a diagnostic accuracy of 94.7%, sensitivity of 98.3%, specificity of 89.2%, PPV of 93.4%, and NPV of 97.1% in the evaluation of implant integrity. Conclusions: Our results show that US is a very reliable alternative in evaluating breast implant integrity and could be the investigation of choice for implant rupture, while MRI could be advocated only in inconclusive cases. Uneven implant shell was found to be the most important US sign of breast implant rupture. Based on the findings, we recommend performing US examination after breast augmentation surgery with silicone gel-filled implants annually.


Assuntos
Implantes de Mama , Implantes de Mama/efeitos adversos , Feminino , Humanos , Lituânia , Imageamento por Ressonância Magnética , Falha de Prótese , Estudos Retrospectivos , Géis de Silicone/efeitos adversos
20.
Acta Cir Bras ; 36(5): e360505, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34133505

RESUMO

PURPOSE: To evaluate capsules formed by microtextured silicone implants with and without Parietex® mesh coverage histologically. METHODS: Sixty Wistar rats were divided in two groups (meshed and unmeshed). Each group was, then, divided into two subgroups for evaluation at 30 and 90 days. Capsules were analyzed based on hematoxylin and eosin (HE) and picrosirius staining. RESULTS: The number of fibroblasts, neutrophils and macrophages was similar among all subgroups. There was a higher lymphocyte reaction in the 30-day meshed group (p = 0.003). Giant cell reaction, granulation tissue and neoangiogenesis were similar among the subgroups. Synovial metaplasia was milder at 90-day in the unmeshed (p = 0.002) and meshed group (p < 0.001). Capsular thickness was significantly greater in the meshed samples (30-day p < 0.001 and 90-day p < 0.001). There was a similar amount of collagen types I and III in both groups. CONCLUSIONS: The mesh-covered implants produced capsules similar to the microtextured ones when analyzing inflammatory variables. Synovial metaplasia was milder at 90 than at 30 days, and the capsular thickness was significantly greater in the meshed group. A similar amount of collagen types I and III was observed. Due to these characteristics, the mesh coverage did not seem to significantly affect the local inflammatory activity.


Assuntos
Implantes de Mama , Silicones , Animais , Implantes de Mama/efeitos adversos , Cápsulas , Colágeno , Feminino , Poliésteres , Ratos , Ratos Wistar , Telas Cirúrgicas/efeitos adversos
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