Effects of fibrin, XXXX , and blood on breast capsule formation in a preclinical model.

@entity32 @entity95 @entity11328
BACKGROUND: The root cause of capsular contracture (CC) associated with breast implants is unknown. Recent evidence points to the possible role of fibrin and bacteria in CC formation. OBJECTIVES: The authors sought to determine whether fibrin, @entity11328 , and blood modulated the histological and microbiological outcomes of breast implant capsule formation in a @entity95 model. METHODS: The authors carried out a case-control study to assess the influence of fibrin, @entity11328 , and blood on capsule wound healing in a @entity95 model. Eighteen New Zealand white @entity95 received four tissue expanders. One expander acted as a control, whereas the other expander pockets received one of the following: fibrin glue, @entity95 blood, or @entity11328 sealant. Intracapsular pressure/volume curves were compared among the groups, and histological and microbiological evaluations were performed (capsules, tissue expanders, @entity95 skin, and air). The @entity95 were euthanized at two or four weeks. RESULTS: At four weeks, the fibrin and @entity11328 expanders demonstrated significantly decreased intracapsular pressure compared to the control group. In the control and fibrin groups, mixed @entity32 correlated with decreased intracapsular pressure, whereas mononuclear @entity32 correlated with increased intracapsular pressure. The predominant isolate in the capsules, tissue expanders, and @entity95 skin was coagulase-negative staphylococci. For fibrin and @entity11328 , both cultures that showed an organism other than staphylococci and cultures that were negative were associated with decreased intracapsular pressure, whereas cultures positive for staphylococci were associated with increased intracapsular pressure. CONCLUSIONS: Fibrin application during breast implantation may reduce rates of CC, but the presence of staphylococci is associated with increased capsule pressure even in the presence of fibrin, so care should be taken to avoid bacterial contamination.
