orabase and Contracture

Antiadhesive barrier solution (AABS) has been proven to prevent intraabdominal adhesion by reducing inflammation and fibrosis formation. Because this mechanism can also be applied to capsule formation after the breast implant insertion, we hypothesize that AABS can reduce capsular contraction and evaluate the efficacy of AABS on perisilastic implant capsule formation after submuscular insertion. A silicone block was inserted beneath the panniculus carnosus muscle in 10 rats. The experiment group received 0.1 mL of AABS (Guardix, Hanmi Medical Co.) instilled into the pocket, whereas the control group received 0.1 mL saline solution. Periimplant capsules were excised after 4 weeks and were evaluated for inflammatory cell count, capsular thickness, collagen pattern, and amount of myofibroblast. The inflammatory cell count and the capsular thickness were lower in the experiment group than in the control group (P < 0.05). The collagen pattern was loose and parallel in the experiment group, and the amount of myofibroblast was much less compared with the control group. AABS reduced the amount of inflammatory cells, myofibroblast, and capsular thickness. It also made the collagen fibers in the capsule loose and parallel. Therefore, AABS seemed to be effective in reducing the periimplant capsule formation.

Topics: Animals; Breast Implantation; Carboxymethylcellulose Sodium; Cell Count; Contracture; Disease Models, Animal; Drug Combinations; Hyaluronic Acid; Immunohistochemistry; Male; Rats; Rats, Sprague-Dawley; Silicones; Tissue Adhesions

Treatment once extension contracture of the knee has completed is difficult and costly. The most effective treatment might be the prevention of contracture, especially after joint injury. In order to establish an effective method for contracture prevention we first made an extension contracture in rabbit knees, then studied the effect of a sheet made from hyaluronic acid and carboxymethyl cellulose (HA/CMC) for the prevention of knee contracture. One hundred and twenty two mature male Japanese white rabbits were divided into three groups: (1) group B (n=42), where bony holes were made at the medial and lateral epicondyles, (2) group H (n=40), where HA/CMC sheets were placed on the bony holes, and (3) group S (n=40),where only arthrotomy was performed. All surgical procedures were performed on the right knees. All right knees were fixed at 45 degrees using external fixators; this is the maximum extension angle the rabbit is able to tolerate and still walk. At 1, 3, and 6 weeks after surgery, we measured the moment necessary to flex the knee using a special device. We defined the moment as flexion moment (FM). Forty four left knees were also tested as group N, not operated on and serving as the healthy side. In all groups, FM was increased parallel to the increment of flexion angle from 45 degrees to 115 degrees . At many flexion angles, the FM in group B was higher than those of group S at 3 and 6 weeks. The FM in group H was significantly lower than those of group B at 85 degrees and 95 degrees of flexion at 6 weeks after the operation. By macroscopic observation, the area and degree of adhesion were greater in group B than those of group S. In group H, adhesions around the bony hole were less evident than in group B at 6 weeks after the operation. By histological examination, dense granulation tissue was found adjacent to the bony hole in group B at 3 and 6 weeks after the operation. In contrast, in group H the amount of granulation tissue was smaller at 3 and 6 weeks after the operation than those of group B. The usage of HA/CMC sheet should be effective for prevention of contracture occurring after trauma such as treatment for intra-articular fracture.

Topics: Analysis of Variance; Animals; Biomechanical Phenomena; Carboxymethylcellulose Sodium; Contracture; Hyaluronic Acid; Knee Joint; Male; Rabbits; Statistics, Nonparametric; Tissue Adhesions