Regenerative Tissue Matrix Protects Against Radiation-Induced Capsular Contracture in a New In-Vivo Model of Silicone Implant Breast Reconstruction

2010 ◽  
Vol 126 ◽  
pp. 129
Author(s):  
Ercan Cihandide ◽  
Adnan Uzunismail ◽  
Elif Eren Aydin ◽  
Sidika Kurul ◽  
Kayvan Shokrollahi
Keyword(s):  
Breast Reconstruction ◽  
Capsular Contracture ◽  
Silicone Implant ◽  
In Vivo Model ◽  
Radiation Induced ◽  
Tissue Matrix ◽  
Implant Breast Reconstruction

scholarly journals 1443 Comparison of Outcomes Between Immediate Direct-to-Implant Breast Reconstruction versus Two-Stage Implant Breast Reconstruction; a Systematic Review and Meta-analysis

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
O Kelly ◽  
I Balasubramanian ◽  
C Cullinane ◽  
R Prichard
Keyword(s):  
Systematic Review ◽  
Breast Reconstruction ◽  
Meta Analysis ◽  
Capsular Contracture ◽  
Tissue Expander ◽  
Immediate Breast Reconstruction ◽  
Two Stage ◽  
Significant Difference ◽  
Implant Reconstruction ◽  
Implant Breast Reconstruction

Abstract Background Direct-to-implant (DTI) breast reconstruction is increasingly performed as the preferred method of immediate breast reconstruction following mastectomy. The proposed advantages of DTI over two-stage tissue expander (TE)/implant reconstruction relate to fewer surgical procedures. This systematic review and meta-analysis aims to evaluate the safety and efficacy of DTI versus conventional TE/implant breast reconstruction. Method A systematic review was performed (PubMed, Embase, Scopus) to identify relevant studies that compared outcomes between DTI and TE/Implant reconstructions. Publications up to October 2020 were included. The primary outcome was overall complication rate. Secondary outcomes included infection rate and implant loss. Results Nineteen studies, including 32,971 implant-based breast reconstructions, were analysed. Median age was 48 years. Mean BMI was 25.9. There was no statistically significant difference between the two groups. Duration of follow up ranged from 1-60 months. Overall complications were significantly more likely to occur in the DTI group (OR 1.81 [1.17-2.79]). Overall complications refers to all reported complications including seroma, haematoma, would dehiscence, infection, skin necrosis and capsular contracture. Implant loss was also significantly higher in the DTI cohort (OR 1.31 [1.12-1.78]). There was no significant difference in infection rates between the two groups. Subgroup analyses, focusing on high-powered multicentre studies showed that the risks of overall complications were significantly higher in the DTI group (OR 1.51 [1.06-2.14]). Conclusions This meta-analysis demonstrates significantly greater risk of complications and implant loss in the DTI breast reconstruction group. These findings serve to aid both patients and clinicians in the decision-making process regarding implant reconstruction following mastectomy

scholarly journals Silicone Implants Immobilized with Interleukin-4 Promote the M2 Polarization of Macrophages and Inhibit the Formation of Fibrous Capsules

Polymers ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 2630
Author(s):  
Hyun-Seok Kim ◽  
Seongsoo Kim ◽  
Byung-Ho Shin ◽  
Chan-Yeong Heo ◽  
Omar Faruq ◽  
...  
Keyword(s):  
Tissue Regeneration ◽  
Capsular Contracture ◽  
Silicone Implant ◽  
Interleukin 4 ◽  
Silicone Implants ◽  
M2 Macrophage ◽  
Macrophage Phenotype ◽  
Arginase 1

Breast augmentations with silicone implants can have adverse effects on tissues that, in turn, lead to capsular contracture (CC). One of the potential ways of overcoming CC is to control the implant/host interaction using immunomodulatory agents. Recently, a high ratio of anti-inflammatory (M2) macrophages to pro-inflammatory (M1) macrophages has been reported to be an effective tissue regeneration approach at the implant site. In this study, a biofunctionalized implant was coated with interleukin (IL)-4 to inhibit an adverse immune reaction and promoted tissue regeneration by promoting polarization of macrophages into the M2 pro-healing phenotype in the long term. Surface wettability, nitrogen content, and atomic force microscopy data clearly showed the successful immobilization of IL-4 on the silicone implant. Furthermore, in vitro results revealed that IL-4-coated implants were able to decrease the secretion of inflammatory cytokines (IL-6 and tumor necrosis factor-α) and induced the production of IL-10 and the upregulation of arginase-1 (mannose receptor expressed by M2 macrophage). The efficacy of this immunomodulatory implant was further demonstrated in an in vivo rat model. The animal study showed that the presence of IL-4 diminished the capsule thickness, the amount of collagen, tissue inflammation, and the infiltration of fibroblasts and myofibroblasts. These results suggest that macrophage phenotype modulation can effectively reduce inflammation and fibrous CC on a silicone implant conjugated with IL-4.

scholarly journals Longitudinal Comparison of Enzyme- and Laser-Treated Intervertebral Disc by MRI, X-Ray, and Histological Analyses Reveals Discrepancies in the Progression of Disc Degeneration: A Rabbit Study

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Marion Fusellier ◽  
Pauline Colombier ◽  
Julie Lesoeur ◽  
Samy Youl ◽  
Stéphane Madec ◽  
...  
Keyword(s):  
Animal Models ◽  
Intervertebral Disc ◽  
Disc Degeneration ◽  
Enzyme Treatment ◽  
In Vivo Model ◽  
Regenerative Approach ◽  
Radiation Induced ◽  
Longitudinal Comparison ◽  
Ivd Degeneration

Regenerative medicine is considered an attractive prospect for the treatment of intervertebral disc (IVD) degeneration. To assess the efficacy of the regenerative approach, animal models of IVD degeneration are needed. Among these animal models, chemonucleolysis based on the enzymatic degradation of the Nucleus Pulposus (NP) is often used, but this technique remains far from the natural physiopathological process of IVD degeneration. Recently, we developed an innovative animal model of IVD degeneration based on the use of a laser beam. In the present study, this laser model was compared with the chemonucleolysis model in a longitudinal study in rabbits. The effects of the treatments were studied by MRI (T2-weighted signal intensity (T2wsi)), radiography (IVD height index), and histology (NP area and Boos’ scoring). The results showed that both treatments induced a degeneration of the IVD with a decrease in IVD height and T2wsi as well as NP area and an increase in Boos’ scoring. The enzyme treatment leads to a rapid and acute process of IVD degeneration. Conversely, laser radiation induced more progressive and less pronounced degeneration. It can be concluded that laser treatment provides an instrumental in vivo model of slowly evolving IVD degenerative disease that can be of preclinical relevance for assessing new prophylactic biological treatments of disc degeneration.

scholarly journals Activation of guanylate cyclase C signaling pathway protects intestinal epithelial cells from acute radiation-induced apoptosis

2009 ◽  
Vol 296 (4) ◽  
pp. G740-G749 ◽  
Author(s):  
M. P. Garin-Laflam ◽  
K. A. Steinbrecher ◽  
J. A. Rudolph ◽  
J. Mao ◽  
M. B. Cohen
Keyword(s):  
Guanylate Cyclase ◽  
Peptide Hormone ◽  
In Vivo Model ◽  
Proximal Jejunum ◽  
Intestinal Epithelial ◽  
Γ Irradiation ◽  
Guanylate Cyclase C ◽  
Radiation Induced ◽  
Induced Apoptosis

Uroguanylin (UGN) is a peptide hormone that binds to and activates the intestinal epithelial cell (IEC) transmembrane receptor guanylate cyclase C (GC-C), which in turn increases intracellular cGMP. Gene targeting of murine UGN or GC-C results in significantly lower levels of cGMP in IECs. On the basis of effects of cGMP in nonintestinal systems, we hypothesized that loss of GC-C activation would increase intestinal epithelial apoptosis following radiation-induced injury. We first compared apoptosis from the proximal jejunum of C57BL/6 wild-type (WT) and GC-C knockout (KO) mice 3 h after they received 5 Gy of γ-irradiation. We then investigated whether supplementation via intraperitoneal injection of 1 mM 8BrcGMP would mitigate radiation-induced apoptosis in these experimental animals. Identical experiments were performed in BALB/c UGN WT and KO mice. Apoptosis was assessed by quantitating morphological indications of cell death, terminal dUTP nick-end labeling, and cleaved caspase 3 immunohistochemistry. Both UGN KO and GC-C KO mice were more susceptible than their WT littermates in this in vivo model of apoptotic injury. Furthermore, cGMP supplementation in both GC-C and UGN KO animals ameliorated radiation-induced apoptosis. Neither WT strain demonstrated significant alteration in apoptotic susceptibility as a result of cGMP supplementation before radiation injury. These in vivo findings demonstrate increased radiosensitivity of IECs in UGN and GC-C KO mice and a role for cGMP as a primary downstream mediator of GC-C activation in the protection of these IECs from radiation-induced apoptosis.

scholarly journals Comparison of Harmonic scalpel and monopolar cautery for capsulectomy at the second stage of expander/implant breast reconstruction

2020 ◽  
Vol 47 (2) ◽  
pp. 140-145
Author(s):  
Ki Jae Kim ◽  
Jae Ho Chung ◽  
Hyung Chul Lee ◽  
Byung Il Lee ◽  
Seung Ha Park ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Harmonic Scalpel ◽  
Capsular Contracture ◽  
Retrospective Chart Review ◽  
Good Alternative ◽  
Postoperative Outcomes ◽  
Two Stage ◽  
Drainage Volume ◽  
Significant Difference ◽  
Implant Breast Reconstruction

Background Capsular contracture is a common complication of two-stage expander/implant breast reconstruction. To minimize the risk of this complication, capsulectomy is performed using monopolar cautery or ultrasonic surgical instrumentation, the latter of which can be conducted with a Harmonic scalpel. To date, there is disagreement regarding which of the two methods is superior. The purpose of this study was to compare postoperative outcomes between a group of patients who underwent surgery using a Harmonic scalpel and another group treated with monopolar cautery.Methods A retrospective chart review was conducted of patients who underwent capsulectomy as part of two-stage breast reconstruction between January 2018 and February 2019 and who received at least 1 month of follow-up after surgery. Operative time and postoperative outcomes, including drainage duration, were analyzed.Results In total, 36 female patients underwent capsulectomy. The monopolar group consisted of 18 patients and 22 breasts, while the Harmonic scalpel group consisted of 18 patients and 21 breasts. There was no statistically significant difference in demographics between the two groups. The Harmonic scalpel group had a significantly shorter mean drainage duration (6.65 days vs. 7.36 days) and a smaller mean total drainage volume (334.69 mL vs. 433.54 mL) than the monopolar cautery group (P<0.05). No statistically significant difference was observed with regard to seroma or hematoma formation.Conclusions The Harmonic scalpel approach for capsulectomy reduced the total drainage volume and drainage duration compared to the monopolar cautery approach. Therefore, this approach could serve as a good alternative to electrocautery.

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