Vacuum Sealing Drainage in the Treatment of Migrated Polyacrylamide Hydrogel after Breast Augmentation: A Case Report

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Abstract

Background: Polyacrylamide hydrogel (PAAG) injection for breast augmentation can result in a variety of complications, including implant migration. The migrated PAAG can become colonized by pathogens, resulting in secondary infections which can be extremely difficult to treat. Case Report: We report the case of a 43-year-old female patient who underwent PAAG injection for breast augmentation. Implant migration was diagnosed 8 years after the initial injection. Conclusion: Here, we report the first use of vacuum sealing drainage as a convenient and effective alternative to manage the complications of extensive PAAG migration after breast augmentation.

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Effects of vacuum-assisted closure on wound microcirculation: an experimental study.

Wen-Xue Li, Qi-Jing Li, Shun Xu … (2005)

To study the mechanism through which vacuum-assisted closure (VAC) induces an increase in blood flow and reduces oedema on skin wounds. Thirty-two Japanese large-ear white rabbits were used. A round full-thickness skin defect (retaining the perichondrium), 2 cm in diameter, was created on each dorsal ear. The wound on the left ear was assigned to the experimental group, and the wound on the right ear to the control group. In the experimental group, the sterile foam dressing was trimmed to the appropriate size and geometry for the given wound and placed into the wound defect. The surface of the wound containing the foam dressing was covered with an adhesive drape to create an airtight seal. Afterwards, negative pressures of -5, -10, -15 and -20 kPa were exerted on the same wound, each lasting for 20 minutes, at intervals of 10 minutes. In the control group, the wound was treated with petrolatum gauze only. At different time points, the microcirculation microscope and image pattern analysis were used to observe the variation in wound microcirculation through a detective window. It was found that VAC promoted capillary blood flow velocity, increased capillary calibre and blood volume, stimulated endothelial proliferation and angiogenesis, narrowed endothelial spaces, and restored the integrity of the capillary basement membrane. By increasing capillary calibre and blood volume and by stimulating angiogenesis, VAC could improve blood circulation in wounds. By narrowing endothelial spaces and by restoring the integrity of capillary basement membranes, VAC could decrease the permeability of blood vessels and wound oedema.

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A review of topical negative pressure therapy in wound healing: sufficient evidence?

C.M. Mouës, F Heule, S.E.R. Hovius (2011)

Topical negative pressure (TNP) therapy has become a useful adjunct in the management of various types of wounds. However, the TNP system still has characteristics of a "black box" with uncertain efficacy for many users. We extensively examined the effectiveness of TNP therapy reported in research studies. A database search was undertaken, and over 400 peer-reviewed articles related to the use of TNP therapy (animal, human, and in vitro studies) were identified. Almost all encountered studies were related to the use of the commercial VAC device (KCI Medical, United States). Mechanisms of action that can be attributed to TNP therapy are an increase in blood flow, the promotion of angiogenesis, a reduction of wound surface area in certain types of wounds, a modulation of the inhibitory contents in wound fluid, and the induction of cell proliferation. Edema reduction and bacterial clearance, mechanisms that were attributed to TNP therapy, were not proven in basic research. Copyright © 2011 Elsevier Inc. All rights reserved.

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Vacuum-assisted closure therapy increases local interleukin-8 and vascular endothelial growth factor levels in traumatic wounds.

Ladislav Mica, Daniela Mihic-Probst, Mario Rancan … (2009)

Clinical observations are suggesting accelerated granulation tissue formation in traumatic wounds treated with vacuum-assisted closure (VAC). Aim of this study was to determine the impact of VAC therapy versus alternative Epigard application on local inflammation and neovascularization in traumatic soft tissue wounds. Thirty-two patients with traumatic wounds requiring temporary coverage (VAC n = 16; Epigard n = 16) were included. At each change of dressing, samples of wound fluid and serum were collected (n = 80). The cytokines interleukin (IL)-6, IL-8, vascular endothelial growth factor (VEGF), and fibroblast growth factor-2 were measured by ELISA. Wound biopsies were examined histologically for inflammatory cells and degree of neovascularization present. All cytokines were found to be elevated in wound fluids during both VAC and Epigard treatment, whereas serum concentrations were negligible or not detectable. In wound fluids, significantly higher IL-8 (p < 0.001) and VEGF (p < 0.05) levels were detected during VAC therapy. Furthermore, histologic examination revealed increased neovascularization (p < 0.05) illustrated by CD31 and von Willebrand factor immunohistochemistry in wound biopsies of VAC treatment. In addition, there was an accumulation of neutrophils as well as an augmented expression of VEGF (p < 0.005) in VAC wound biopsies. This study suggests that VAC therapy of traumatic wounds leads to increased local IL-8 and VEGF concentrations, which may trigger accumulation of neutrophils and angiogenesis and thus, accelerate neovascularization.

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Author and article information

Journal

Journal ID (publisher-id): BRC

Journal ID (pmc): BRC

Journal ID (doi): 10.1159/issn.1661-3791

Title: Breast Care

Publisher: S. Karger AG

ISSN (Print): 1661-3791

ISSN (Electronic): 1661-3805

Publication date Subscription-year: 2014

Publication date (Print): August 2014

Publication date (Electronic): 14 August 2014

Volume: 9

Issue: 4

Pages: 273-275

Affiliations

Department of Plastic and Reconstructive Surgery, No. 117 PLA Hospital, Hangzhou, China

Article

Publisher ID: 365954 Pmcid ID: PMC4209280 Other ID: Breast Care 2014;9:273-275

DOI: 10.1159/000365954

PMC ID: PMC4209280

PubMed ID: 25404887

SO-VID: 560a812b-921c-4971-8a79-3f53f5d0e20f

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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

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Vacuum Sealing Drainage in the Treatment of Migrated Polyacrylamide Hydrogel after Breast Augmentation: A Case Report

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Abstract

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Karger: Oncology

Most cited references 6

Effects of vacuum-assisted closure on wound microcirculation: an experimental study.

A review of topical negative pressure therapy in wound healing: sufficient evidence?

Vacuum-assisted closure therapy increases local interleukin-8 and vascular endothelial growth factor levels in traumatic wounds.

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