title: The impact of triamcinolone acetonide in early breast capsule formation in a rabbit model.
abstract: BACKGROUND
  The etiology and clinical treatment of capsular contracture remain unresolved as the causes may be multifactorial. Triamcinolone acetonide applied in the pocket during surgery was reported to be ineffective in prevention of capsular contracture. However, if injected 4-6 weeks after surgery or as a treatment for capsular contracture, decreased applanation tonometry measurements and pain were observed. It was assumed that intraoperative application of triamcinolone was not effective because its effect does not last long enough. However, betadine, antibiotics, and fibrin were found to be effective in preventing capsular contracture with intraoperative applications and are more effective in the early phases of wound healing than in later stages. The role of triamcinolone acetonide in capsule formation is unknown. The purpose of this study was to determine if triamcinolone acetonide modulates breast capsule formation or capsular contracture in the early phases of wound healing in a rabbit model.
  
  
  METHODS
  Rabbits (n=19) were implanted with one tissue expander and two breast implants and were killed at 4 weeks. Implant pocket groups were (1) Control (n=10) and (2) Triamcinolone (n=9). Pressure/volume curves and histological, immunological, and microbiological evaluations were performed. Operating room air samples and contact skin samples were collected for microbiological evaluation.
  
  
  RESULTS
  In the triamcinolone group, a decreased capsular thickness, mild and mononuclear inflammation, and negative or mild angiogenesis were observed. There were no significant differences in intracapsular pressure, fusiform cell density, connective tissue, organization of collagen fibers, and microbiological results between the groups. There was no significant difference in the dialysate levels of IL-8 and TNF-α, but correlation between IL-8 and TNF-α was observed.
  
  
  CONCLUSIONS
  Triamcinolone acetonide during breast implantation influences early capsule formation and may reduce capsular contracture.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at www.springer.com/00266.
authors.affiliation: Faculty of Medicine, University of Oporto, Porto, Portugal, marisamarquesmd@gmail.com.
authors.forename: Marisa
authors.initials: M
authors.lastname: Marques
authors.forename: Spencer
authors.initials: S
authors.lastname: Brown
authors.forename: Inês
authors.initials: I
authors.lastname: Correia-Sá
authors.forename: M Natália
authors.initials: MN
authors.lastname: D S Cordeiro
authors.forename: Pedro
authors.initials: P
authors.lastname: Rodrigues-Pereira
authors.forename: Acácio
authors.initials: A
authors.lastname: Gonçalves-Rodrigues
authors.forename: José
authors.initials: J
authors.lastname: Amarante
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D018427:Breast Implants / Q000009:adverse effects*; D003238:Connective Tissue / Q000187:drug effects* / Q000473:pathology; D004195:Disease Models, Animal; D057910:Implant Capsular Contracture / Q000209:etiology / Q000378:metabolism / Q000473:pathology* / Q000517:prevention & control*; D011817:Rabbits; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*
chemical_list: D000893:Anti-Inflammatory Agents; D014222:Triamcinolone Acetonide