假体乳房重建术(隆乳术)后包膜挛缩及其与感染相关性研究进展  

Progress in capsular contracture following breast reconstructure(augmentation mammaplasty)and its correction with subclinical(biofilm) infection

作　　者：汤琦[1] 黄云超[2] 

机构地区：[1]昆明医科大学第三附属医院乳腺病科,云南昆明650118 [2]昆明医科大学第三附属医院胸心血管外科,云南昆明650118

出　　处：《中国医药科学》2013年第17期54-57,106,共5页China Medicine And Pharmacy

基　　金：云南省科技计划项目(2012FB070)

摘　　要：总结假体乳房重建术后包膜挛缩及其与假体(生物材料)植入后感染的相关性的研究进展,为乳腺外科防治生物材料感染及相关并发症提供有益帮助。在pubme数据库检索SCI收录英文文献,关键词为"Staphylococcus epidermidis,biomaterial,biofilms,subclinical infection,capsular contracture"。CNKI数据库检索中文文献,关键词为"表皮葡萄球菌,生物材料,生物膜,包膜挛缩"。对检索到的文献进行初审,选取有关包膜挛缩发生及防治,假体植入术后感染,生物材料植入与表皮葡萄球菌感染及亚临床感染与包膜挛缩相关性研究文献近90篇,排除重复性研究,选择其中有代表性的35篇进行综述。(1)包膜挛缩是假体重建术后最常见的并发症;(2)表皮葡萄球菌是假体植入术后感染最常见的致病菌,生物膜的形成是导致感染发生的关键因素;(3)感染引起的局部炎症反应导致大量的炎细胞聚集,刺激纤维母细胞增生,合成胶原纤维,胶原合成与降解失衡,导致包膜组织的异常纤维化而发生挛缩。表皮葡萄球菌生物膜相关的假体植入术后感染对包膜挛缩的发生发展起重要作用。进一步提高假体(生物材料)的相容性,抑制或阻断生物膜的形成,对假体植入后感染相关的包膜挛缩的防治具有重要临床价值和意义。To sum up progress in capsular contracture following breast reconstructure and its correction with subclinical （biofilm） infection. Provide useful help to breast surgeons to prevent and cambat the implant-associated infection. A computer-based on line search of the related articles published in English in pubmed database and articles published in Chinese in CNKI database with the key words of ＂Staphylococcus epidermidis, biomaterial, biofilms, infection, capsular contracture＂. All the articles were selected firstly to choose those about the occurrence and prevention of capsular contracture, infection following prosthesis implantation, implanted biomaterial associated infection and biofilm of staphylococcus epidermidis and subclinical infection causes capsular contracure. Totally 90 articals were collected and the repeated researches were excluded, 35 articles were selected to review. （1）Capsular contracture has remained the most significant clinical complication of breast reconstructure; （2）Staphylococcus epidermidis is the most common pathogen, which causes infection in breast implants, and the main factor is biofilm formation; （3）Local inflammation caused by infection made a large number of inflammatory cells gathered, fibroblast proliferate and synthesize collagen fiber. Imbalances of Collagen synthesis and degradation, which lead to capsular tissue fibrosis and capsular contracture. Biofilm formation by Staphylococcus epidermidis on the outer surface of a silicone breast implant is strongly associated with capsular contracture formation. Improve the compatibility of prosthesis （biomaterial） and against biofilm-forming, which is significant to prevent biofilm-induced capsular contracture.

关 键 词：包膜挛缩 乳房假体 亚临床感染 表皮葡萄球菌 生物膜 

分 类 号：R655.8[医药卫生—外科学]