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      Avaliação da absorção de proteínas em ratas submetidas à colocação de mini-implantes de silicone nanotexturizados e revestidos pela espuma de poliuretano Translated title: Evaluation of protein adsorption in rats submitted to nanotextured and polyurethane foam-coated silicone mini-implants

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          Abstract

          RESUMO Introdução: O controle da absorção de proteínas é necessário para a definição das propriedades dos biomateriais e de seus usos específicos. O plasma sanguíneo contém diversas proteínas diferentes, dentre elas o fibrinogênio, que apresenta importante papel na adesão celular e nos resultados de biocompatibilidade em implantes. Os objetivos deste estudo foram avaliar laboratorialmente as ratas submetidas à colocação de mini-implantes de silicone nanotexturizados e revestidos por espuma de poliuretano a partir da aferição do fibrinogênio sérico e mensuração da proteína plasmática. Métodos: Foram utilizadas 60 ratas albinas, divididas em dois grupos de 30 animais para cada tipo de mini-implante de silicone (nanotexturizado e espuma de poliuretano) e subdivididas em 3 subgrupos, conforme o tempo de eutanásia dos animais (30, 60 e 90 dias). Os mini-implantes foram inseridos no dorso dos animais abaixo do Panniculus carnosus. No momento das eutanásias, amostras de sangue foram obtidas por punção cardíaca. Utilizou-se a técnica de precipitação térmica para determinação das proteínas plasmáticas total e sérica, e o valor do fibrinogênio foi obtido mediante a diferença entre estas duas últimas. Resultados: Quando comparados os grupos entre si, observou-se que o grupo nanotexturizado apresentou uma maior quantidade de fibrinogênio e da proteína plasmática no subgrupo de 90 dias, com significância estatística (p=0,004). Ao comparar os subgrupos entre si, em ambos os grupos, evidenciou-se uma diferença significativa (p<0,001). Conclusão: Os mini-implantes nanotexturizados mostraram uma menor absorção de proteínas em relação aos implantes revestidos pela espuma de poliuretano, no subgrupo de 90 dias.

          Translated abstract

          ABSTRACT Introduction: The control of protein absorption is necessary to define biomaterials' properties and their specific uses. Blood plasma contains several different proteins, including fibrinogen, which plays an important role in cell adhesion and biocompatibility results in implants. This study's objectives were to evaluate in the laboratory rats subjected to the placement of nano-textured silicone mini-implants and polyurethane foam-coated mini-implants based on the measurement of serum fibrinogen and plasma proteins. Methods: Sixty albino rats were used, divided into two groups of 30 animals for each type of silicone mini-implant (nanotextured and polyurethane foam) and subdivided into three subgroups, according to the animals' euthanasia time (30, 60 and 90 days). The mini-implants were inserted in the animals' backs below the Panniculus carnosus. At the time of euthanasia, blood samples were obtained by cardiac puncture. The thermal precipitation technique was used to determine total and serum plasma proteins, and the difference between the latter two obtained the fibrinogen value. Results: When the groups were compared, it was observed that the nanotextured group presented a higher amount of fibrinogen and plasma protein in the 90-day subgroup, with statistical significance (p=0.004). When comparing the subgroups among themselves, a significant difference was evidenced (p<0.001). Conclusion: The nanotextured mini-implants showed a lower protein absorption concerning polyurethane foam-coated implants in the 90-day subgroup.

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          Capsular Contracture after Breast Augmentation: An Update for Clinical Practice

          Capsular contracture is the most common complication following implant based breast surgery and is one of the most common reasons for reoperation. Therefore, it is important to try and understand why this happens, and what can be done to reduce its incidence. A literature search using the MEDLINE database was conducted including search terms 'capsular contracture breast augmentation', 'capsular contracture pathogenesis', 'capsular contracture incidence', and 'capsular contracture management', which yielded 82 results which met inclusion criteria. Capsular contracture is caused by an excessive fibrotic reaction to a foreign body (the implant) and has an overall incidence of 10.6%. Risk factors that were identified included the use of smooth (vs. textured) implants, a subglandular (vs. submuscular) placement, use of a silicone (vs. saline) filled implant and previous radiotherapy to the breast. The standard management of capsular contracture is surgical via a capsulectomy or capsulotomy. Medical treatment using the off-label leukotriene receptor antagonist Zafirlukast has been reported to reduce severity and help prevent capsular contracture from forming, as has the use of acellular dermal matrices, botox and neopocket formation. However, nearly all therapeutic approaches are associated with a significant rate of recurrence. Capsular contracture is a multifactorial fibrotic process the precise cause of which is still unknown. The incidence of contracture developing is lower with the use of textured implants, submuscular placement and the use of polyurethane coated implants. Symptomatic capsular contracture is usually managed surgically, however recent research has focussed on preventing capsular contracture from occurring, or treating it with autologous fat transfer.
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            Textured surface breast implants in the prevention of capsular contracture among breast augmentation patients: a meta-analysis of randomized controlled trials.

            Capsular contracture is a common complication associated with the use of breast implants. Numerous randomized controlled trials addressing the efficacy of textured surface breast implants in reducing capsular contracture have yielded nonuniform results. This meta-analysis addresses the use of textured breast implants in the prevention of capsular contracture. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials databases were searched to identify all randomized controlled trials involving the use of textured versus smooth breast implants. The results of these trials were meta-analyzed to obtain a pooled odds ratio of the effect of textured surfacing on capsular contracture rates. In addition, subgroup analyses were performed based on implant type (saline or silicone gel), type of surface texturing (Siltex or Biocell), placement (subglandular or submuscular), and length of follow-up. Eleven trials were reviewed. Four were excluded because they failed to meet a priori inclusion criteria. The remaining seven trials were meta-analyzed. Only three of these studies found significantly lower rates of capsular contracture with the use of textured implants. However, when all seven studies were pooled, the odds ratio was found to be 0.19 (95 percent confidence interval, 0.07 to 0.52), indicating a protective effect for surface texturing on the rate of capsular contracture. Submuscular placement was the only subgroup in which significance was not achieved. However, this subgroup consisted of a single study, which was dramatically underpowered. The results of this meta-analysis demonstrate the superiority of textured over smooth breast implants in decreasing the rate of capsular contracture.
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              Current Risk Estimate of Breast Implant–Associated Anaplastic Large Cell Lymphoma in Textured Breast Implants

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                Author and article information

                Journal
                rbcp
                Revista Brasileira de Cirurgia Plástica
                Rev. Bras. Cir. Plást.
                Sociedade Brasileira de Cirurgia Plástica (São Paulo, SP, Brazil )
                1983-5175
                2177-1235
                July 2021
                : 36
                : 3
                : 257-262
                Affiliations
                [2] São Paulo São Paulo orgnameUniversidade Federal de São Paulo orgdiv1Programa de Pós-Graduação em Cirurgia Translacional Brazil
                [1] Ponta Grossa Paraná orgnameUniversidade Estadual de Ponta Grossa Brazil
                [3] Rio de Janeiro RJ orgnameUniversidade Estadual do Rio de Janeiro orgdiv1Programa de Pós-Graduação em Fisiopatologia e Ciências Cirúrgicas Brasil
                Article
                S1983-51752021000300257 S1983-5175(21)03600300257
                10.5935/2177-1235.2021rbcp0045
                12464604-b19b-4e6d-8099-c5ef0f30ba89

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 01 December 2020
                : 10 January 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 24, Pages: 6
                Product

                SciELO Brazil

                Categories
                Artigos Originais

                Blood proteins,Rats,Mammoplasty,Breast implants,Experimental implants,Ratos,Mamoplastia,Implantes de mama,Implantes experimentais,Proteínas sanguíneas

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