scholarly journals Functionalization of Silicone Surface with Drugs and Polymers for Regulation of Capsular Contracture

Polymers ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 2731
Author(s):  
Omar Faruq ◽  
Pham Ngoc Chien ◽  
Nilsu Dönmez ◽  
Sun-Young Nam ◽  
Chan-Yeong Heo
Keyword(s):  
Surface Modification ◽  
Foreign Body ◽  
Breast Reconstruction ◽  
Drug Loading ◽  
Capsular Contracture ◽  
Bacterial Attachment ◽  
Silicone Implants ◽  
Clinical Approach ◽  
Foreign Body Reactions ◽  
Silicone Surface

Breast reconstruction is achieved using silicone implants, which are currently associated with major complications. Several strategies have been considered to overcome the existing limitations as well as to improve their performance. Recently, surface modification has proved to be an effective clinical approach to prevent bacterial adhesion, reduce capsular thickness, prevent foreign body reactions, and reduce other implant-associated problems. This review article summarizes the ongoing strategies for the surface modification of silicone implants in breast reconstruction applications. The article mostly discusses two broad categories of surface modification: drug-mediated and polymer-based. Different kinds of drugs have been applied with silicone that are associated with breast reconstruction. Initially, this article discusses studies related to drugs immobilized on silicone implants, focusing on drug-loading methods and their effects on capsule contracture. Moreover, the pharmacological action of drugs on fibroblast cells is considered in this section. Next, the polymeric modification of the silicone surface is introduced, and we discuss its role in reducing capsule thickness at the cellular and biological levels. The polymeric modification techniques, their chemistry, and their physical properties are described in detail. Notably, polymer activities on macrophages and inflammation are also briefly discussed. Each of the reviewed articles is summarized, highlighting their discussion of capsular thickness, foreign body reactions, and bacterial attachment. The aim of this review is to provide the main points of some research articles regarding the surface modification of silicon, which can lead to a decrease in capsular thickness and provides better patient compliance.

Dual surface modification of PDMS-based silicone implants to suppress capsular contracture

2018 ◽  
Vol 76 ◽  
pp. 56-70 ◽  
Author(s):  
Byoung Yong Yoo ◽  
Byung Hwi Kim ◽  
Jae Sang Lee ◽  
Byung Ho Shin ◽  
Heeyeon Kwon ◽  
...  
Keyword(s):  
Surface Modification ◽  
Capsular Contracture ◽  
Silicone Implants

scholarly journals Anatomic Implants in Breast Reconstruction: A Comparison of Outcomes and Aesthetic Results Compared to Smooth Round Silicone Implants

2019 ◽  
Vol 39 (8) ◽  
pp. NP322-NP330 ◽  
Author(s):  
Nneamaka Agochukwu-Nwubah ◽  
Ashley Boustany ◽  
Margaret Wetzel ◽  
Jacob Maus ◽  
Brian Rinker
Keyword(s):  
Breast Reconstruction ◽  
Chart Review ◽  
Capsular Contracture ◽  
Retrospective Chart Review ◽  
Well Being ◽  
Silicone Implants ◽  
Body Type ◽  
Level Of Evidence ◽  
Aesthetic Results ◽  
Implant Reconstruction

Abstract Background Direct comparison studies of outcomes and aesthetic satisfaction of anatomic implants compared to other implants are scarce in the literature. Objectives The objective of this study was to compare outcomes and aesthetic satisfaction of patients who underwent breast reconstruction with anatomic implants vs other implants (smooth round silicone). Methods A retrospective chart review was performed of patients who underwent implant-based breast reconstruction over 3 years. Outcomes including complications, number of surgeries, need for revisions, and aesthetic satisfaction of patients were tracked and compared. Results A total of 156 patients met inclusion criteria for this study. A total of 123 underwent reconstruction with a round implant, and 33 underwent reconstruction with an anatomic implant. Of the 156 patients, 38 underwent a 1-stage direct-to-implant reconstruction and the remainder underwent a 2-stage implant reconstruction. The round and anatomic implant groups did not differ with regards to number of surgeries, revisions, utilization of contralateral symmetry procedures, implant-related reoperations, complications, implant loss, infection, capsular contracture, and seroma. The Breast Q survey had a response rate of 27%. On all parameters, the round and anatomic implant groups did not significantly differ. Conclusions There were no significant differences among round and shaped implants in regards to complications, revision surgeries, and overall outcomes. Furthermore, patients showed no differences regarding satisfaction and well-being when surveyed on the Breast Q survey. The decision of implant choice in breast reconstruction should be based on surgeon comfort and the patient’s needs/body type. Level of Evidence: 4

scholarly journals Prepectoral reconstruction with polyurethane-coated implant after skin-sparing mastectomy in patients with breast cancer

2020 ◽  
Vol 7 (3) ◽  
pp. 63-73
Author(s):  
M. Yu. Vlasova ◽  
A. D. Zikiryakhodzhaev ◽  
I. V. Reshetov ◽  
A. S. Sukhotko ◽  
E. K. Saribekyan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
World Literature ◽  
Capsular Contracture ◽  
Functional Results ◽  
Pectoral Muscle ◽  
Silicone Implants ◽  
Operation Technique ◽  
Female Population ◽  
The World

Breast cancer is one of the most frequently diagnosed malignancies in the Russian Federation (RF), accounting for 20.9% of the female population in Russia. The surgery remains the primary treatment for breast cancer. Development and improvement of various options for reconstructive plastic surgery provides medical, psychological and social rehabilitation in patients with breast cancer, allows to achieve the best aesthetic and functional results. The possibility of performing such operations contributes to improving the quality of life of patients. According to ASPS (American Society of Plastic Surgeons), 80% of breast cancer reconstructions in the world are performed using silicone implants. Currently, the return of prepectoral space for placement of endoprostheses during breast reconstruction is trending, which is associated not only with the improvement of mastectomy techniques, but also with the coating of implants and the appearance of silicone highly adhesive gel filling of implants. According to the world literature data, the use of polyurethane-coated endoprostheses for prepectoral/subcutaneous reconstruction reduces the risk of capsular contracture, provides a more reliable fixation to the surrounding tissues, and thus allows breast reconstruction without the need for additional cover of the endoprosthesis. The use of the prepectoral space is characterized by a simpler operation technique compared to the retromuscular placement of the implant, the absence of damage to the large pectoral muscle, minimization of pain, reduction of the bed-day in the hospital and a faster rehabilitation period. So, this type of breast reconstruction can be considered as an alternative to submuscular implant placement in primary operable forms of breast cancer with sufficient thickness of the integumentary tissues.

Polymeric Nanoparticles for Brain Drug Delivery - A Review

2020 ◽  
Vol 21 (9) ◽  
pp. 649-660
Author(s):  
Subashini Raman ◽  
Syed Mahmood ◽  
Ayah R. Hilles ◽  
Md Noushad Javed ◽  
Motia Azmana ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Surface Modification ◽  
Polymeric Nanoparticles ◽  
Drug Loading ◽  
Preparation Methods ◽  
Brain Drug Delivery ◽  
Polymeric Nanoparticle ◽  
Relationship Of ◽  
The Relationship ◽  
The Brain

Background: Blood-brain barrier (BBB) plays a most hindering role in drug delivery to the brain. Recent research comes out with the nanoparticles approach, is continuously working towards improving the delivery to the brain. Currently, polymeric nanoparticle is extensively involved in many therapies for spatial and temporal targeted areas delivery. Methods: We did a non-systematic review, and the literature was searched in Google, Science Direct and PubMed. An overview is provided for the formulation of polymeric nanoparticles using different methods, effect of surface modification on the nanoparticle properties with types of polymeric nanoparticles and preparation methods. An account of different nanomedicine employed with therapeutic agent to cross the BBB alone with biodistribution of the drugs. Results: We found that various types of polymeric nanoparticle systems are available and they prosper in delivering the therapeutic amount of the drug to the targeted area. The effect of physicochemical properties on nanoformulation includes change in their size, shape, elasticity, surface charge and hydrophobicity. Surface modification of polymers or nanocarriers is also vital in the formulation of nanoparticles to enhance targeting efficiency to the brain. Conclusion: More standardized methods for the preparation of nanoparticles and to assess the relationship of surface modification on drug delivery. While the preparation and its output like drug loading, particle size, and charge, permeation is always conflicted, so it requires more attention for the acceptance of nanoparticles for brain delivery.

scholarly journals Long-term outcomes of two-stage, immediate and delayed breast reconstruction with polyurethane-covered versus textured implants: protocol of a prospective, multicentre randomised controlled trial (TIPI trial)

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e044219
Author(s):  
J X Harmeling ◽  
Kevin Peter Cinca ◽  
Eleni-Rosalina Andrinopoulou ◽  
Eveline M L Corten ◽  
M A Mureau
Keyword(s):  
Randomised Controlled Trial ◽  
Breast Reconstruction ◽  
Controlled Trial ◽  
Capsular Contracture ◽  
Tissue Expander ◽  
Complication Rates ◽  
Two Stage ◽  
Randomised Controlled

IntroductionTwo-stage implant-based breast reconstruction is the most commonly performed postmastectomy reconstructive technique. During the first stage, a tissue expander creates a sufficiently large pocket for the definite breast implant placed in the second stage. Capsular contracture is a common long-term complication associated with implant-based breast reconstruction, causing functional complaints and often requiring reoperation. The exact aetiology is still unknown, but a relationship between the outer surface of the implant and the probability of developing capsular contracture has been suggested. The purpose of this study is to determine whether polyurethane-covered implants result in a different capsular contracture rate than textured implants.Methods and analysisThe Textured Implants versus Polyurethane-covered Implants (TIPI) trial is a multicentre randomised controlled trial with a 1:1 allocation rate and a follow-up of 10 years. A total of 321 breasts of female adults undergoing a two-stage breast reconstruction will be enrolled. The primary outcome is capsular contracture at 10-year follow-up which is graded with the modified Baker classification. It is analysed with survival analysis using a frailty model for clustered interval-censored data, with both an intention-to-treat and per-protocol approach. Secondary outcomes are other complication rates, surgical revision rate, patient satisfaction and quality of life and user-friendliness. Outcomes are measured 2 weeks, 6 months, 1, 2, 3, 5 and 10 years postoperatively. Interim analysis is performed when 1-year, 3-year and 5-year follow-up is completed.Ethics and disseminationThe trial has been reviewed and approved by the Medical Research Ethics Committee of the Erasmus MC, University Medical Centre Rotterdam (MEC-2018-126) and locally by each participating centre. Written informed consent will be obtained from each study participant. The results will be disseminated by publication in peer-reviewed journals.Trial registrationNTR7265.

Early Failure of a Polyvinyl Alcohol Hydrogel Implant With Osteolysis and Foreign Body Reactions in an Ovine Model of Cartilage Repair

2021 ◽  
pp. 036354652110336
Author(s):  
Marta Cercone ◽  
Jacqueline Chevalier ◽  
John G. Kennedy ◽  
Andrew D. Miller ◽  
Lisa A. Fortier
Keyword(s):  
Computed Tomography ◽  
Foreign Body ◽  
Polyvinyl Alcohol ◽  
Failure Rate ◽  
Synovial Membrane ◽  
Quantitative Computed Tomography ◽  
Macrophage Infiltration ◽  
Ovine Model ◽  
Foreign Body Reactions ◽  
Pva Hydrogel

Background: Hemiarthroplasty using a polyvinyl alcohol (PVA) hydrogel synthetic implant has been suggested as a good alternative to arthrodesis for the treatment of hallux rigidus. However, failure rates as high as 20% have been recorded. Purpose: To characterize the pathological processes in bone, cartilage, and the synovial membrane after PVA hemiarthroplasty in an ovine model with 6 months of follow-up. Study Design: Controlled laboratory study. Methods: A unilateral osteochondral defect (8-mm diameter × 10-mm depth) was made in the medial femoral condyle in 6 sheep. Animals were randomized to receive a PVA implant (n = 4) or to have an empty defect (n = 2) and were monitored for 6 months. Patellofemoral radiographs were obtained at monthly intervals, and quantitative computed tomography was performed at the end of the study. After death, the joints were macroscopically evaluated and scored. Osteochondral and synovial membrane histological findings were assessed using modified Osteoarthritis Research Society International (OARSI) and aseptic lymphocyte-dominated vasculitis-associated lesion (ALVAL) scoring systems. Immunohistochemistry using Iba1 was performed to evaluate activated macrophage infiltration. Results: Overall, 2 sheep with PVA implants were euthanized at 1 and 5 months because of uncontrollable pain and lameness (failed implants). Quantitative computed tomography showed that sheep with failed implants had 2.1-fold more osteolysis than those with successful implants. The sheep with failed implants had osteoarthritis with extensive glycosaminoglycan loss and cartilage fibrillation of the condyle and opposing tibial surface on histological examination. A foreign body reaction with severe chronic lymphoplasmacytic and granulomatous inflammation with giant cells was detected surrounding the implant. The synovial membrane ALVAL score was 9 of 19 and 14 of 19 in failed implants with synovial hyperplasia and lymphoplasmacytic and macrophage infiltration. In contrast, the synovial membrane in successful implants and empty defects was normal (ALVAL score = 0/19). Immunolabeling for Iba1 in failed implants confirmed extensive and dense macrophage infiltration within the condyle and synovial membrane, with the highest immunoreactive score (9/9). Conclusion: PVA hydrogel implants had a 50% failure rate with uncontrollable pain, severe osteolysis, inflammation, and foreign body reactions. Clinical Relevance: The failure rate and pathological characteristics of the PVA implants suggest that their use should not be continued in human patients without further in vivo safety studies.

Experimental oral foreign body reactions

1990 ◽  
Vol 69 (6) ◽  
pp. 713-719 ◽  
Author(s):  
Carol M. Stewart ◽  
Ronald E. Watson
Keyword(s):  
Foreign Body ◽  
Foreign Body Reactions
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