Effects of Coagulase-Negative Staphylococci and Fibrin on Breast Capsule Formation in a Rabbit 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; Lara Queiros (Author) Other; Andre Luis (Author) Other; Rui Freitas (Author) Other; Acacio Goncalves Rodrigues (Author) FMUP; Jose Amarante (Author) FMUP

Journal

Title: Aesthetic Surgery Journal

Vol. 31

Pages: 420-428

ISSN: 1090-820X

Publisher: Oxford University Press

Indexing

ISI Web of Knowledge - 17 Citations

Scopus - 18 Citations

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Other information

Authenticus ID: P-002-RKF

DOI: 10.1177/1090820x11404400

Abstract (EN): Background: The etiology and ideal clinical treatment of capsular contracture (CC) remain unresolved. Bacteria, especially coagulase-negative staphylococci, have been previously shown to accelerate the onset of CC. The role of fibrin in capsule formation has also been controversial. Objective: The authors investigate whether fibrin and coagulase-negative staphylococci (CoNS) modulate the histological, microbiological, and clinical outcomes of breast implant capsule formation in a rabbit model and evaluate contamination during the surgical procedure. Methods: Thirty-one New Zealand white female rabbits were each implanted with one tissue expander and two breast implants. The rabbits received (1) untreated implants and expanders (control; n = 10), (2) two implants sprayed with 2 mL of fibrin and one expander sprayed with 0.5 mL of fibrin (fibrin; n = 11), or (3) two implants inoculated with 100 mu L of a CoNS suspension (10(8)CFU/mL-0.5 density on the McFarland scale) and one expander inoculated with a CoNS suspension of 2.5 x 10(7) CFU/mL (CoNS; n = 10). Pressure/volume curves and histological and microbiological evaluations were performed. Operating room air samples and contact skin samples were collected for microbiological evaluation. The rabbits were euthanized at four weeks. Results: In the fibrin group, significantly decreased intracapsular pressures, thinner capsules, loose/dense (<25%) connective tissue, and negative/mild angiogenesis were observed. In the CoNS group, increased capsular thicknesses and polymorph-type inflammatory cells were the most common findings. Similar bacteria in capsules, implants, and skin were cultured from all the study groups. One Baker grade IV contracture was observed in an implant infected with Micrococcus spp. Conclusions: Fibrin was associated with reduced capsule formation in this preclinical animal model, which makes fibrin an attractive potential therapeutic agent in women undergoing breast augmentation procedures. Clinical strategies for preventing bacterial contamination during surgery are crucial, as low pathogenic agents may promote CC.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9