title: Prevention of capsular contracture with Guardix-SG(®) after silicone implant insertion.
abstract: BACKGROUND
  Capsular contracture is the most common side effect of breast implant insertion and the problem that breast surgeons seek to avoid the most. Previous animal studies have proved that an antiadhesive barrier solution (AABS) prevents peri-implant capsule formation. In this study, the authors sought to explore the effect that Guardix-SG(®), an AABS that can encapsulate implants in the form of a gel, can have on capsular contracture.
  
  
  METHODS
  This study used 12 female New Zealand white rabbits weighing 2.5-3 kg. Implants were inserted into the subpanniculus carnosus plane through an incision in the bilateral midback area. Once the implant was inserted, 3 g of Guardix-SG(®) and normal saline were instilled into the left and right sides, respectively. The rabbits were killed 6 months after the procedure. The intracapsular pressure was measured using tonometry with a 38.2-g circular glass piece, and capsular thickness was measured by dyeing the biopsy specimen with hematoxylin and eosin and Masson's trichrome stain. The myofibroblasts were quantitatively analyzed through monoclonal anti-alpha smooth muscle actin antibody immunohistochemistry staining.
  
  
  RESULTS
  The intracapsular pressure in the control group (4.51 ± 0.98 mmHg) was significantly higher (p = 0.002) than in the study group (3.51 ± 0.4 mmHg). The average capsular thickness was significantly greater in the control group (0.33 ± 0.15 mm; p = 0.015). In the analysis, the interrelation between capsular thickness and intracapsular pressure was insignificant in both groups, as was the number of myofibroblasts in both groups (p = 0.582).
  
  
  CONCLUSIONS
  Through this study, the authors were able to demonstrate that capsular contracture can be suppressed in the rabbit model by instilling Guardix-SG(®) after insertion of cohesive gel implants in the subpanniculus carnosus plane.
  
  
  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 www.springer.com/00266 .
authors: Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, 101, Daehang-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea.
authors: Seong Oh
authors: SO
authors: Park
authors: Jihyeon
authors: J
authors: Han
authors: Kyung Won
authors: KW
authors: Minn
authors: Ung Sik
authors: US
authors: Jin
mesh_terms: D000464:Alginates / Q000627:therapeutic use*; D000818:Animals; D019928:Breast Implantation / Q000009:adverse effects*; D018427:Breast Implants / Q000009:adverse effects*; D004195:Disease Models, Animal; D005260:Female; D057927:Hydrophobic and Hydrophilic Interactions; D057910:Implant Capsular Contracture / Q000209:etiology / Q000517:prevention & control*; D008365:Manometry; D020442:Poloxamer / Q000627:therapeutic use*; D011126:Polypropylenes; D011474:Prosthesis Design; D011817:Rabbits; D012826:Silicone Elastomers
chemical_list: D000464:Alginates; D011126:Polypropylenes; D012826:Silicone Elastomers; D020442:Poloxamer