Introduction

Breast implants are associated with complications such as capsular contracture, implant rupture and leakage often necessitating further corrective surgery. Re-operation rates have been reported to occur in up to 15.4% of primary augmentation patients and up to 27% in primary reconstructions patients within the first three years (Cunningham, 2007). The aim of this study was to examine the mechanical and surface chemical properties as well as the fibroblast response of retrieved breast implants in our unit to determine the in vivo changes which occur over time.

Methods

Ethical approval was obtained. 47 implants were retrieved. Implantation time ranged from 1 month to 388 months (Mean 106.1 months). Tensile strength, elongation, Young's modulus and tear strength properties were measured using Instron 5565 tensiometer on anterior and posterior aspects of the implant. Attenuated total reflectance-fourier transform infra-red spectroscopy (ATR-FTIR), wettability and scanning electron microscopy (SEM) analysis was performed on the shell surfaces. Bicinchoninic acid assay was performed to determine shell protein content. The fibroblast response was determined by seeding HDFa cells on the retrieved implants and cell metabolism measured using Alamar Blue™ assay.

Results

Mechanical properties fall with increasing duration of implantation. There were no significant changes in ATR-FTIR spectra between ruptured and intact implants nor significant changes in wettability in implants grouped into 5 year categories. SEM imaging reveals surface degradation changes with increasing duration of implantation.

Conclusions

With increasing duration of implantation, mechanical properties of the breast implants fall. However this was not associated with surface chemical changes as determined by ATR-FTIR and wettability nor protein content of the shells. Thus the reduction in mechanical properties is associated with breast implant failure but further research is required to elucidate the mechanisms.

中文翻译：

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从单个中心对回收的乳房植入物进行机械和表面化学分析。

介绍

乳房植入物与诸如囊膜挛缩，植入物破裂和渗漏等并发症相关，通常需要进一步的矫正手术。据报道，在头三年内，高达15.4％的原发性增生患者和高达27％的原发重建患者发生了再手术率（Cunningham，2007年）。这项研究的目的是检查我们单位中回收的乳房植入物的机械和表面化学性质以及成纤维细胞反应，以确定随时间推移发生的体内变化。

方法

已获得道德认可。取回了47个植入物。植入时间为1个月至388个月（平均106.1个月）。使用Instron 5565张力计在植入物的前部和后部测量拉伸强度，伸长率，杨氏模量和撕裂强度特性。在壳表面进行了衰减全反射傅里叶变换红外光谱（ATR-FTIR），润湿性和扫描电子显微镜（SEM）分析。进行比辛可宁酸测定以确定壳蛋白含量。通过将HDFa细胞播种在回收的植入物上并使用Alamar Blue™测定法测量细胞代谢来确定成纤维细胞反应。

结果

机械性能随植入时间的延长而下降。破裂和完整的植入物之间的ATR-FTIR光谱没有显着变化，而分组为5年类别的植入物的润湿性也没有显着变化。SEM成像显示，表面降解随植入时间的延长而变化。

结论

随着植入时间的延长，乳房植入物的机械性能下降。但是，这与通过ATR-FTIR和润湿性确定的表面化学变化无关，也与壳中的蛋白质含量无关。因此，机械性能的下降与乳房植入物的失败有关，但是需要进一步的研究来阐明其机理。