Effects of Fibrin, Thrombin, and Blood on Breast Capsule Formation in a Preclinical Model

• Type: Article in International Scientific Journal
• Date: 2011

Authors

Marisa Marques (Author) FMUP; Spencer A Brown (Author) Other; Natalia D S Cordeiro (Author) FCUP; Pedro Rodrigues Pereira (Author) Other; Luis Cobrado, ML (Author) Other; Aliuska Morales Helguera (Author) Other; Nuno Lima (Author) Other; Andre Luis (Author) Other; Mario Mendanha (Author) Other; Acacio Goncalves Rodrigues (Author) FMUP; Jose Amarante (Author) FMUP

Journal

Title: Aesthetic Surgery Journal

Vol. 31

Pages: 302-309

ISSN: 1090-820X

Publisher: Oxford University Press

Indexing

ISI Web of Knowledge - 14 Citations

Scopus - 15 Citations

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Other information

Authenticus ID: P-002-TAK

DOI: 10.1177/1090820x11398351

Abstract (EN): 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, thrombin, and blood modulated the histological and microbiological outcomes of breast implant capsule formation in a rabbit model. Methods: The authors carried out a case-control study to assess the influence of fibrin, thrombin, and blood on capsule wound healing in a rabbit model. Eighteen New Zealand white rabbits received four tissue expanders. One expander acted as a control, whereas the other expander pockets received one of the following: fibrin glue, rabbit blood, or thrombin sealant. Intracapsular pressure/volume curves were compared among the groups, and histological and microbiological evaluations were performed (capsules, tissue expanders, rabbit skin, and air). The rabbits were euthanized at two or four weeks. Results: At four weeks, the fibrin and thrombin expanders demonstrated significantly decreased intracapsular pressure compared to the control group. In the control and fibrin groups, mixed inflammation correlated with decreased intracapsular pressure, whereas mononuclear inflammation correlated with increased intracapsular pressure. The predominant isolate in the capsules, tissue expanders, and rabbit skin was coagulase-negative staphylococci. For fibrin and thrombin, 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.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 8