Year 2013 Vol. 21 No 3




SBEE HPE Tver State Medical Academy
The Russian Federation

Objectives. Using morphological methods to estimate the reaction of the organism tissues and degradation processes of silicone implants after their application in clinical conditions.
Methods. The connective tissue capsules formed around various silicone mammary implants were studied by applying the method of light microscopy.
Results. It was revealed that after implantation of a volume soft foreign body (silicone mammary implants) this material presented in the tissues for a long period of time delimited by a fibrous capsule. Gradually the capsule compresses owing to the activity of myofibroblasts for minimization of the volume of an alien body, its internal surface is deformed and obtains a wavy form with a set of outgrowths or protrudes inside. The connective tissue capsule formed around silicone implants consists of dense (external, main) and friable (internal, boundary) parts. The tight part of a capsule isolates a foreign body from the organism tissues. A gradual destruction (fragmentation) and absorption of implant material by phagocytes occurs in friable part. Over time the silicone migrates to capsular tissues and out of its limits where it is absorbed by phagocytes. As the result of silicone migration in tissues and its uptake by phagocytes the volume of mammary implants gradually decreases and the capsule is reduced to meet the volume of the foreign body, the inner part of the capsule is wave-like deformed. A significant manifestation of granulomatous inflammation and the formation of a thick capsule with signs of fibrosis are considered as unfavorable prognostic signs pointing to a higher likelihood of developing various complications in the future.
Conclusions. The more inactive for a live organism the implant material is the less it will stimulate macrophage reaction. The problem of new implant design is in the search for the most bioinert materials, strong enough for compression by a capsule and fragmentation, but similar on elasticity with normal tissue of a mammary gland.

Keywords: silicone, capsular contraction, giant cells of foreign body, granulomatous inflammation
p. 23 32 of the original issue
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Address for correspondence:
170000, Rossiiskaia Federatsiia, g. Tver', ul. Sovetskaia, d. 4, GBOU VPO "Tverskaia gosudarstvennaia meditsinskaia akademiia", kafedra obshchei khirurgii,
Sergeev Aleksei Nikolaevich
Information about the authors:
Mokhov EM. MD, professor, a head of the chair of general surgery GBOU VPO "Tver State Medical Academy."
Sergeev AN. PhD, associate professor of general surgery chair GBOU VPO "Tver State Medical Academy."
Serov EV. A surgeon of Solnechnogorsk CRH of Moscow region, an applicant of general surgery chair GBOU VPO "Tver State Medical Academy."
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