Silikon implant konmuş sıçanlarda aselüler dermal matriks kullanımının kapsül kontraksiyonu üzerine etkisi
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Date
2014
Authors
Şakı, Mehmet Can
Journal Title
Journal ISSN
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Publisher
Uludağ Üniversitesi
Abstract
Estetik ve rekonstrüktif amaçlı meme cerrahisi, plastik cerrahi ameliyatları içerisinde önemli bir yer kaplamaktadır. Silikon meme implantlarının kullanılmaya başlandığı son elli yılda meme büyütme ve mastektomi sonrası meme rekonstrüksiyonu ameliyatlarının sayısında dramatik bir artış olmuştur. İmplant etrafında gözlenen kapsül kontraksiyonu bu hasta gruplarında ikincil ameliyatı gerektiren en sık komplikasyondur. Bu komplikasyonun önlenmesinde ve tedavisinde aselüler dermal matriks içeren ürünler sıklıkla kullanılmaktadır. Bu nedenle, aselüler dermal matriks içeren yeni bir ürün olan Belladerm®'in etkinliğini deneysel olarak araştırdık. Belladerm®'in kapsül dokusu oluşumu üzerindeki etkilerini, yara iyileşme sürecinde görülen hücresel dinamikleri göz önünde bulundurarak, inceledik. Deneysel çalışmamızda, sıçan pektoral kası kesilerek silikon implantların yerleşeceği subpektoral cepler oluşturuldu. Oniki deneğe sadece silikon implant; diğer onikisine ise Belladerm® ile sarılmış silikon implant yerleştirildi. Altı haftalık takipten sonra her iki deney grubunda implant etrafında oluşan kapsül dokusu histolojik incelemeye alındı. Histolojik incelemede Hematoksilen-Eozin ve Masson Trikrom boyamaları yapılan parçalar tek bir uzman histolog tarafından değerlendirildi. Histopatolojik değerlendirmede gruplar arasında, polimorfonükleer lökosit hücre yoğunluğu, mononükleer lökosit hücre yoğunluğu, neovaskülarizasyon, kollajen liflerin miktarı, fibrozis ve kronik inflamasyon gibi parametrelere bakıldı. Sonuç olarak; Belladerm®'in rezorpsiyona uğramadığı ve dokuyla entegrasyona girdiği deneysel olarak kanıtlanmış oldu. Ancak geç dönem kapsül kontraksiyonu oluşumu üzerine etkisi hakkında bilgi edinilemedi
Cosmetic and reconstructive breast surgery occupies a central role in plastic surgery operations. The number of breast augmentations and postmastectomy breast reconstructions dramatically increased since silicone breast implants were introduced in the past fifty years. However capsular contraction around slicone implants remains a challenging complication which is the most common reason for revision surgeries in these patients. Application of acellular dermal matrices for prevention and treatment of capsular contracture is handled by many surgeons. Therefore, we used Belladerm® in our study which is newly introduced in the marketplace. We investigated the effects of Belladerm® on capsular contracture by defining the cellular dynamics of wound healing process. In our study, subpectoral pockets were created by cutting pectoralis muscles of twenty-four rats. We placed only silicone implants in twelve rats and we placed silicone implants circumferentially wrapped with Belladerm® in another twelve rats. Capsule tissue samples around silicone implants were obtained for histologic evaluation after six weeks interval. Tissue samples were stained by H&E and Masson's Trichrome. In the histopathological evaluation, the following parameters were scored: the intensity of polymorfonuclear and mononuclear leucocytes, neovascularization, the thickness of collagen fibers around the implants and the rates of fibrosis and chronic inflammation. In conclusion, we documented that Belladerm® integrates to the surrounding tissue and is not resorbed by host tissue cells. However, we did not expand our study in order to observe the effects of Belladerm® on late capsular contracture.
Cosmetic and reconstructive breast surgery occupies a central role in plastic surgery operations. The number of breast augmentations and postmastectomy breast reconstructions dramatically increased since silicone breast implants were introduced in the past fifty years. However capsular contraction around slicone implants remains a challenging complication which is the most common reason for revision surgeries in these patients. Application of acellular dermal matrices for prevention and treatment of capsular contracture is handled by many surgeons. Therefore, we used Belladerm® in our study which is newly introduced in the marketplace. We investigated the effects of Belladerm® on capsular contracture by defining the cellular dynamics of wound healing process. In our study, subpectoral pockets were created by cutting pectoralis muscles of twenty-four rats. We placed only silicone implants in twelve rats and we placed silicone implants circumferentially wrapped with Belladerm® in another twelve rats. Capsule tissue samples around silicone implants were obtained for histologic evaluation after six weeks interval. Tissue samples were stained by H&E and Masson's Trichrome. In the histopathological evaluation, the following parameters were scored: the intensity of polymorfonuclear and mononuclear leucocytes, neovascularization, the thickness of collagen fibers around the implants and the rates of fibrosis and chronic inflammation. In conclusion, we documented that Belladerm® integrates to the surrounding tissue and is not resorbed by host tissue cells. However, we did not expand our study in order to observe the effects of Belladerm® on late capsular contracture.
Description
Keywords
Kapsül kontraksiyonu, Aselüler dermal matriks, Belladerm®, Silikon implant, Estetik ve rekonstrüktif meme cerrahisi, Capsular contraction, Acellular dermal matrix, Silicone implants, Aesthetic and reconstructive breast surgery
Citation
Şakı, M. C. (2014). Silikon implant konmuş sıçanlarda aselüler dermal matriks kullanımının kapsül kontraksiyonu üzerine etkisi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.