The Effects of Colchicine-Impregnated Oxidized Regenerated Cellulose on Capsular Contracture

Abstract

Capsular contracture is the most common complication of breast augmentation. Oxidized regenerated cellulose can be used as a matrix for drug transport. Colchicine is an antimitotic drug that interferes with various steps of wound healing. The aim of this study was to evaluate the effects of oxidized regenerated cellulose alone or in combination with colchicine on capsular contracture. Twenty-one adult female Wistar-Albino rats were divided into 3 groups. In group 1 silicone blocks only, in group 2 oxidized regenerated cellulose-wrapped silicone blocks, and in group 3 colchicine-impregnated oxidized regenerated cellulose-wrapped silicone blocks were inserted in the dorsal region. Four weeks later, implants were removed and histopathological examination was performed. Capsular thickness, inflammatory infiltrate degree, collagen fiber organization, and myofibroblast density were evaluated. Macroscopic examination revealed a distinct capsule formation only in group 1 animals, with average measurement being 134.65 µm on histopathological examination. In groups 2 and 3 animals, no distinct capsule formation was seen. Inflammatory infiltrate degree was found to be less in groups 2 and 3 animals than in group 1 animals. Collagen fiber organization around the implants was found to be parallel and organized in group 1 animals, whereas it was random and disorganized in animals in both groups 2 and 3. High myofibroblast density was observed in animals in groups 1 and 2, while no myofibroblast was found in animals in group 3. The results of our study suggest that coating silicone implants with oxidized regenerated cellulose or with colchicine-impregnated oxidized regenerated cellulose may be effective in preventing capsular contracture.

Current Concepts in Capsular Contracture: Pathophysiology, Prevention, and Management

“…83 Additionally, studies in animal models suggest that various medications such as Vitamin E, colchicine, botox, chitosan, collagenases, omega 3, and doxycycline could potentially be used to prevent the development of capsular contracture. [84][85][86][87][88][89][90] Despite the promise of these experimental therapies, most have not yet been explored in human trials. Continued investigations into novel therapies such as those described here are exciting and could help to substantially improve biologic response to implants and in turn reduce morbidity associated with periprosthetic fibrosis.…”

Current Approaches Including Novel Nano/Microtechniques to Reduce Silicone Implant-Induced Contracture with Adverse Immune Responses

“…Systemic uses and the topical use of colchicine and vitamin E have also been reported [ 89 , 90 ]. In an in vivo study, insertion of silicone implants applied with colchicine resulted in less inflammatory infiltrate, no myofibroblasts, and random and disorganized collagen fibers around the implants compared to the control group, which might result in prevention of capsule formation [ 89 ]. Topical application of vitamin E and croton oil to reduce pseudocapsules around the prosthesis has also been studied [ 90 ].…”

Size matters—in vitro behaviour of human fibroblasts on textured silicone surfaces with different pore sizes

“…Several in vitro and in vivo studies have investigated a possible prophylactic influence of different drugs or modifications of the implants providing no distinct evidence of effectiveness in the past [6]. This includes the administration of Simvastatin, Collagenase or Triamcinolone into capsular tissue and the coating of implants with antibiotics, spider silk, Montelukast or Triamcinolone [7][8][9][10][11][12][13][14][15][16][17][18][19][20].…”