Castel, Nikki
(Department of Surgery, Division of Plastic Surgery, University of Hawai'i, John A. Burns School of Medicine)
,
Soon-Sutton, Taylor
(Department of Surgery, Division of Plastic Surgery, University of Hawai'i, John A. Burns School of Medicine)
,
Deptula, Peter
(Department of Surgery, Division of Plastic Surgery, University of Hawai'i, John A. Burns School of Medicine)
,
Flaherty, Anna
(Department of Surgery, Division of Plastic Surgery, University of Hawai'i, John A. Burns School of Medicine)
,
Parsa, Fereydoun Don
(Department of Surgery, Division of Plastic Surgery, University of Hawai'i, John A. Burns School of Medicine)
Background Polyurethane coating of breast implants has been shown to reduce capsular contracture in short-term follow-up studies. This 30-year study is the longest examination of the use of polyurethane-coated implants and their correlation with capsular contracture. Methods This study evaluates the...
Background Polyurethane coating of breast implants has been shown to reduce capsular contracture in short-term follow-up studies. This 30-year study is the longest examination of the use of polyurethane-coated implants and their correlation with capsular contracture. Methods This study evaluates the senior surgeon's (F.D.P.) experience with the use of polyurethane-coated implants in aesthetic breast augmentation in 382 patients over 30 years. Follow-up evaluations were conducted for six months after surgery. After the six-month follow-up period, 76 patients returned for reoperation. The gross findings, histology, and associated capsular contracture were noted at the time of explantation. Results No patient during the six-month follow-up period demonstrated capsular contracture. For those who underwent reoperation for capsular contracture, Baker II/III contractures were noted nine to 10 years after surgery and Baker IV contractures were noted 12 to 21 years after surgery. None of the explanted implants had macroscopic evidence of polyurethane, which was only found during the first five years after surgery. The microscopic presence of polyurethane was noted in all capsules up to 30 years after the original operation. Conclusions An inverse correlation was found between the amount of polyurethane coating on the implant and the occurrence of capsular contracture. Increasingly severe capsular contracture was associated with a decreased amount of polyurethane coating on the surface of the implants. No contracture occurred in patients whose implants showed incomplete biodegradation of polyurethane, as indicated by the visible presence of polyurethane coating. We recommend research to find a non-toxic, non-biodegradable synthetic material as an alternative to polyurethane.
Background Polyurethane coating of breast implants has been shown to reduce capsular contracture in short-term follow-up studies. This 30-year study is the longest examination of the use of polyurethane-coated implants and their correlation with capsular contracture. Methods This study evaluates the senior surgeon's (F.D.P.) experience with the use of polyurethane-coated implants in aesthetic breast augmentation in 382 patients over 30 years. Follow-up evaluations were conducted for six months after surgery. After the six-month follow-up period, 76 patients returned for reoperation. The gross findings, histology, and associated capsular contracture were noted at the time of explantation. Results No patient during the six-month follow-up period demonstrated capsular contracture. For those who underwent reoperation for capsular contracture, Baker II/III contractures were noted nine to 10 years after surgery and Baker IV contractures were noted 12 to 21 years after surgery. None of the explanted implants had macroscopic evidence of polyurethane, which was only found during the first five years after surgery. The microscopic presence of polyurethane was noted in all capsules up to 30 years after the original operation. Conclusions An inverse correlation was found between the amount of polyurethane coating on the implant and the occurrence of capsular contracture. Increasingly severe capsular contracture was associated with a decreased amount of polyurethane coating on the surface of the implants. No contracture occurred in patients whose implants showed incomplete biodegradation of polyurethane, as indicated by the visible presence of polyurethane coating. We recommend research to find a non-toxic, non-biodegradable synthetic material as an alternative to polyurethane.
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제안 방법
From 1982 until their discontinuation in 1991, 764 polyurethane implants were inserted in 382 patients. All patients were asked to return for follow-up visits at one week, four weeks, six weeks, and six months after surgery.
Our goal in this study was to evaluate the long-term complications of polyurethane-coated breast implants, focusing primarily on capsular contracture and its correlation with the presence of polyurethane coating on the surface of the prosthesis at the time of explantation.
대상 데이터
3 and 4. The remaining seven patients were determined to have Baker IV contracture at office visits that occurred 12, 13, 14, 15, 17, 18, and 21 years after surgery, with a mean follow-up time of 16 years.
후속연구
Studies have shown potential toxicity with polyurethane and our studies have shown that it tends to disintegrate. However, due to its superior aesthetic outcome and significantly lower rates of capsular contracture, we encourage further studies investigating alternative non-biodegradable and non-toxic materials similar in structure to polyurethane. A non-biodegradable material would coat implants for an extended period of time, which would further decrease the incidence of capsular contracture and perhaps eliminate it altogether.
참고문헌 (25)
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