The Effects of Angiotensin-Converting Enzyme Inhibitors on the Fibrous Envelope around Mammary Implants

Zimman, Oscar A.; Toblli, Jorge Eduardo; Stella, Inés; Ferder, Marcelo; Ferder, León; Inserra, Felipe

doi:10.1097/01.prs.0000287381.93729.e2

Cited by 54 publications

(25 citation statements)

References 37 publications

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“…There are collateral effects associated with implants because they stimulate the defense mechanism to eliminate it as a foreign body. Among the materials used in implants, silicone is one of the most inactive materials, due partly to its hydrophobic characteristic that impedes chemical and enzymatic agents to affect the material Many studies attested to the superiority of textured membranes over the smooth ones in capsular reduction 13,14 . This textured quality is directly related to the degree of discontinuity of the capsule and the consequent reduction of its contracture.…”

Section: Discussionmentioning

confidence: 99%

Healing reaction to mammary prostheses covered by textured silicone and silicone foam in rats

et al. 2009

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Purpose:To compare the capsular reaction to two different coverings of silicone prosthesis through the biophysical characteristic of adherence and microscopical aspects of the inflammatory reaction and collagen formation. Methods: Thirty two Wistar rats were used. In the dorsum of each animal a silicone elastomer with a smooth superficies and another coated with texturized silicone (Mentor) was implanted. Another one, with the same smooth superficies and other coated with silicone foam (Lifesil), making up in each side, of the dorsum, the texturized and silicone foam group respectively. The animals were split into four groups to be evaluated at 7, 14, 30 and 60 days. On the evaluation dates the implant adherence was verified witch a tensiometer and the values in kgf were obtained. The material was sent to histological analysis with hematoxilin-eosin and picrosirius colorations, to evaluate the inflammatory reaction and collagen synthesis, respectively. The obtained data were submitted to statistical treatment. Results: There was more adherence of the tissue to the silicone foam (P<0,001). The inflammatory reaction was more intense in the same group, but without statistical significance. The number of giant cells and granulomas were more frequent in the silicone foam group. There was statistical significance at the 60 days for granulomas (P<0,028) and for all subgroups about number of giant cells (P< 0,012 to P<0,036). The thickness of the capsule in the silicone foam group was bigger, with statistical significance at seven days (P<0,028) and 60 days (P<0,012). The collagen deposition showed no difference in statistical analysis. Conclusion: The capsular reaction to the silicone foam showed stronger adherence, bigger thickness and had more number of granulomas and giant cells. No difference was observed in the intensity of inflammatory reaction in relation to type I and III collagen, when compared to the texturized cover. Key words: Breast Implantation. Silicones. Biocompatible Materials. Contracture. Rats. RESUMO Objetivo:Comparar a reação capsular de dois revestimentos de próteses de silicone através da característica biofísica de aderência e dos aspectos microscópicos de reação inflamatória e formação de colágeno. Métodos: Implantaram-se no dorso de 32 ratos duas membranas de silicone ambas possuindo uma superfície lisa e outra diferindo em sua estrutura. Estes revestimentos foram de espuma de silicone (LifeSil) ou silicone texturizado (Mentor). Os dois grupos foram divididos em quatro sub-grupos conforme o tempo de pós-operatório avaliado: 7, 14, 30 e 60 dias. Obteve-se material para análise biofísica de aderência, a qual foi realizada com tensiômetro para obtenção de valores em kgf. O estudo microscópico da reação inflamatória e síntese de colágeno foi realizado com colorações de hematoxilina-eosina e picrosirius. Os dados foram submetidos a testes para avaliação da significância estatística. Resultados: Houve maior aderência do revestimento de espuma de silicone ao tecido capsular, sendo este valor...

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Section: Discussionmentioning

confidence: 99%

Healing reaction to mammary prostheses covered by textured silicone and silicone foam in rats

et al. 2009

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“…The late capsular contracture has an unknown etiology, and it is very difficult to reproduce these phenomena in animal models. It is only possible to reproduce a model of inflammatory reaction to a foreign body [26]. Also, the relationship between the capsule thickness and contracture is controversial.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Montelukast and Antiadhesion Barrier Solution on the Capsule Formation after Insertion of Silicone Implants in a White Rat Model

et al. 2013

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Background and Purposes: Capsular contracture is one of the most severe complications that can occur in breast surgery following silicone implant insertion. The purpose of this study was to investigate the effect of montelukast and antiadhesion barrier solution (AABS) on reducing capsular formation and their possible synergism. Materials andMethods: This study was approved by the Animal Ethics Committee (Reference No. KNU 2012-33) and was conducted in accordance with the Kyungpook National University - Institutional Animal Care and Use Committee, Animal Ethics Committee. The experiments in this study were conducted in vivo in 4 groups of 24 rats. Following silicone implant insertion, the pocket was injected with different agents. Group I (control group) was given normal saline injections into the pocket and fed with pure water. Group II was given injections of AABS and fed with pure water. Group III was given injections of normal saline and the medication montelukast during the experimental period. Group IV was given injections of AABS and montelukast as postoperative medication. Peri-implant capsules were excised after 8 weeks and were evaluated for transparency, inflammatory cell content, capsule thickness, collagen pattern and TGF-β expression. Results: The capsules in the experimental groups (i.e., groups II-IV) were significantly more transparent than those in group I (controls; p < 0.05, Student's t test). The mean capsule thickness of the experimental groups II (296 ± 14.76 μm), III (280 ± 14.77 μm) and IV (276 ± 39.28 μm) was smaller than that of the control group I (361 ± 35.43 μm). Compared to the control group, the histologic findings in the experimental groups suggested a decreased inflammatory response occurring in the peri-implant capsules as they exhibited minor vascularization and a reduced number of mast cells and macrophages. The collagen patterns in the experimental groups were of a lower density than in the control group with the former showing a loose, tidy collagen pattern. The amounts of TGF-β and collagen I were higher in the control group than in the experimental groups. Group IV (the synergic effect group) had a more pronounced effect on all the parameters examined than that in groups II and III with separate drug administration. Conclusions: Montelukast and AABS reduced the thickness, the inflammatory cell infiltrate and the myofibroblast content of the peri-implant capsules around silicone implants in this white rat model. They lowered the expression of the fibrotic mediator, TGF-β, and inhibited the peri-implant capsular fibrosis. Therefore, montelukast and AABS are effective in the reduction of silicone-induced peri-implant capsular formation.

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“…En ellos, fue necesario comenzar un nuevo esquema de antibioticoterapia con trimethoprim/sulfamethoxazole y ciprofloxacina, 500 mg cada 12 horas, durante 8 semanas. Además, todos los casos siguieron durante 90 días con altas dosis de combinación de Vitamina A y E así como con una dosis de enalapril 5 mg (2 tomas por día) para prevenir la contractura capsular (13).…”

Section: Resultsunclassified

Uso de expansores tisulares a modo de soporte cutáneo: presentación de un nuevo dispositivo

Moretti

2015

Cir. plást. iberolatinoam.

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The Effects of Angiotensin-Converting Enzyme Inhibitors on the Fibrous Envelope around Mammary Implants

Cited by 54 publications

References 37 publications

Healing reaction to mammary prostheses covered by textured silicone and silicone foam in rats

Healing reaction to mammary prostheses covered by textured silicone and silicone foam in rats

The Effect of Montelukast and Antiadhesion Barrier Solution on the Capsule Formation after Insertion of Silicone Implants in a White Rat Model

Uso de expansores tisulares a modo de soporte cutáneo: presentación de un nuevo dispositivo

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