PDF(Pubmed)
Abstract：
Breast implants are the most commonly used medical devices in plastic surgery, and capsular contracture (CC) is one of the most common complications. However, our assessment of CC is based largely on Baker grade, which is problematically subjective and affords only four possible values.
The authors performed a systematic review concluding in September of 2021 in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. It identified 19 articles that propose approaches to measuring CC.
In addition to Baker grade, the authors identified several modalities reported to measure CC. These included magnetic resonance imaging, ultrasonography, sonoelastography, mammacompliance measuring devices, applanation tonometry, histologic evaluation, and serology. Capsule thickness and other measures of CC inconsistently correlated with Baker grade, whereas the presence of synovial metaplasia was consistently associated with Baker grade I and II, but not III and IV capsules.
There remains no particular method to reliably and specifically measure the contracture of capsules that form around breast implants. As such, we would recommend that research investigators use more than one modality to measure CC. Other variables that can impact breast implant stiffness and associated discomfort beyond CC need to be considered when evaluating patient outcomes. Given the value placed on CC outcomes in assessing breast implant safety, and the prevalence of breast implants overall, the need for a more reliable approach to measuring this outcome persists.
The authors performed a systematic review concluding in September of 2021 in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. It identified 19 articles that propose approaches to measuring CC.
In addition to Baker grade, the authors identified several modalities reported to measure CC. These included magnetic resonance imaging, ultrasonography, sonoelastography, mammacompliance measuring devices, applanation tonometry, histologic evaluation, and serology. Capsule thickness and other measures of CC inconsistently correlated with Baker grade, whereas the presence of synovial metaplasia was consistently associated with Baker grade I and II, but not III and IV capsules.
There remains no particular method to reliably and specifically measure the contracture of capsules that form around breast implants. As such, we would recommend that research investigators use more than one modality to measure CC. Other variables that can impact breast implant stiffness and associated discomfort beyond CC need to be considered when evaluating patient outcomes. Given the value placed on CC outcomes in assessing breast implant safety, and the prevalence of breast implants overall, the need for a more reliable approach to measuring this outcome persists.
摘要：
背景：乳房植入物是整形外科中最常用的医疗设备，而包膜挛缩是最常见的并发症之一。然而，我们对包膜挛缩的评估主要基于Baker评分，该评分是主观的，仅提供4个可能的值。
方法：我们在2021年9月进行了系统审查，以符合系统审查（PRISMA）指南的首选报告项目。它确定了19篇文章，提出了测量包膜挛缩的方法。
结果：除了贝克的成绩，我们确定了几种据报道测量包膜挛缩的方法。这些包括磁共振成像，超声检查,超声弹性成像,mammacompliance测量装置，压平眼压法，组织学评估，和血清学。胶囊厚度和其他包膜挛缩措施与Baker等级不一致，而滑膜化生的存在与Baker等级1和2，但与3和4个胶囊始终相关。
结论：仍然没有特定的方法来可靠且具体地测量乳房植入物周围形成的胶囊的挛缩。因此，我们建议研究者使用一种以上的方式来测量包膜挛缩.在评估患者结果时，需要考虑可能影响乳房植入物硬度和包膜挛缩以外的相关不适的其他变量。考虑到包膜挛缩结果在评估乳房植入物安全性方面的价值，以及乳房植入物的总体患病率，仍然需要一种更可靠的方法来衡量这一结果。
方法：我们在2021年9月进行了系统审查，以符合系统审查（PRISMA）指南的首选报告项目。它确定了19篇文章，提出了测量包膜挛缩的方法。
结果：除了贝克的成绩，我们确定了几种据报道测量包膜挛缩的方法。这些包括磁共振成像，超声检查,超声弹性成像,mammacompliance测量装置，压平眼压法，组织学评估，和血清学。胶囊厚度和其他包膜挛缩措施与Baker等级不一致，而滑膜化生的存在与Baker等级1和2，但与3和4个胶囊始终相关。
结论：仍然没有特定的方法来可靠且具体地测量乳房植入物周围形成的胶囊的挛缩。因此，我们建议研究者使用一种以上的方式来测量包膜挛缩.在评估患者结果时，需要考虑可能影响乳房植入物硬度和包膜挛缩以外的相关不适的其他变量。考虑到包膜挛缩结果在评估乳房植入物安全性方面的价值，以及乳房植入物的总体患病率，仍然需要一种更可靠的方法来衡量这一结果。
