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Chirurgia di revisione capsulare contrattura



Revisione capsulare contrattura.

La contrattura capsulare è la ragione più comune della revisione della chirurgia del seno. Il tessuto attorno all'impianto diventa più solido come reazione del sistema immunitario a materiale estraneo.

Ci sono 4 gradi di contrattura capsulare dal sistema di classificazione Baker.(1)

Grade I Il seno è normalmente morbido e appare naturale per dimensioni e forma
Grade II  Il seno è un po 'duro ma sembra normale     
Grade III  Il seno è fermo e duro ma  non appare anormale.   
Grade IV   Il seno è duro, doloroso al tatto e appare anormale.     
Grade III-IV necessita di un intervento chirurgico di revisione 

 

Perché si verifica una contrattura capsulare?
Provengono le cause più comuni di contrattura capsulare
1. Tecnica del chirurgo come la contaminazione, ematoma
2. Materiale implantare; la qualità dell'impianto è una variazione, a seconda del materiale e dei produttori
3. Pazienti, sistema immunitario e reazione a materiale estraneo in ogni paziente

 

Come correggerlo?

1. Capsulotomia, il chirurgo espanderà la capsula. Questa tecnica è disponibile per Grado 1-2
2. Capsulectomia, il chirurgo rimuove la capsula che è stata coperta l'impianto per Grado 3-4

 

Incidenza del tasso di recidiva dopo capsulectomia e il posizionamento del nuovo impianto è del 30,7% segnalato da Caffee(2)

 

Riferimento

1. https://en.wikipedia.org/wiki/Capsular_contracture
2. https://journals.lww.com/prsgo/FullText/2016/10000/ Open_Capsulotomy ___An_Effective_but_Overlooked.7.aspx


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