RU2565411C1 - Method for prevention of capsular contracture formation - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: during surgical intervention involving creating a prosthetic bed from both sides, under m. pectoralis major, the bed is irrigated with ozonised normal saline with the ozone concentration of 2-4 mg/l.

EFFECT: method enables eliminating capsular contracture by antibacterial and antimycotic action of ozone with normalising the tissue immunity.

3 dwg, 1 ex

Description

The invention relates to medicine, can be used to prevent the formation of capsular contracture in augmentation mammoplasty and is used in plastic and reconstructive surgery.

A known method for the treatment and prevention of capsular contracture (RF Patent No. 2129029, A61N 5/06, 04/20/1999), including the treatment and prevention of capsular contracture during endoprosthetics of the mammary glands. The soft tissues surrounding the mammoendoprosthesis are irradiated percutaneously over the entire projection area of the surgical intervention zone. Use a laser in a pulsed periodic mode. The wavelengths correspond to the first and second harmonics at the same time. The method provides uniform energy irradiation to a depth from the front to the rear walls of the forming or formed fibrous capsule.

However, this method has disadvantages: it does not allow the prevention of capsular contracture at the stage of the operation; It carries certain risks of exposure to laser radiation on breast tissue, given the fact that sometimes augmentation mammoplasty is performed after or simultaneously with surgical treatment of breast diseases.

The objective of the proposed method is the prevention of capsular contracture.

The task is carried out due to the fact that intraoperatively after creating a bed for prostheses on both sides, under m. pectoralis major, the bed is irrigated with ozonized saline solution with an ozone concentration of 2-4 mg / L.

The method is as follows:

After processing the surgical field under general anesthesia, the retromammar space is detached with paraareolar access; then longitudinally dissect the superficial fascia and the anterior fascia leaf m. pectoralis major with subsequent muscle detachment with the creation of a bed for prostheses on both sides. The prosthesis bed is irrigated with an ozonized physiological solution with an ozone concentration of 2-4 mg / l, obtained by sparging a physiological solution for 2 minutes with an ozone-oxygen mixture developed at the UOTA-60 unit of the Medozon production association. Set silicone prostheses of the mammary glands in the space under m. pectoralis major. Control for hemostasis. The postoperative wound is sutured in layers. Apply an aseptic dressing. Put on compression underwear.

Clinical example: patient K., 34 years old, diagnosed with admission: postlactational involution of the mammary glands. Operation: Augmentation mammoplasty. After processing the surgical field under general anesthesia, the retromammary space was detached with paraareolar access; then a longitudinal dissection of the superficial fascia and the anterior fascia leaf m. pectoralis major followed by muscle detachment with the creation of a bed for prostheses on both sides (Fig. 1). The prosthesis bed is irrigated with ozonized saline solution with an ozone concentration of 2-4 mg / l, obtained by sparging the saline solution for 2 minutes with an ozone-oxygen mixture developed at the UOTA-60 unit of the Medozon production association. Silicone prostheses of mammary glands are installed in the space under m. pectoralis major (Fig. 2). Control for hemostasis. The postoperative wound is sutured in layers. An aseptic dressing is applied. Compression underwear.

Dressings for 10 days. Postoperative sutures were removed on day 11. Postoperative scar without signs of inflammation. The mammary glands are symmetrical; moderate postoperative edema of the soft tissues is noted. Recommended: continuous wearing of compression underwear for 4 weeks, limitation of physical activity for 12 weeks.

Examination a month (4 weeks) after surgery: no complaints, the mammary glands are symmetrical, no edema, palpation moderately intense. Postoperative scars are normotrophic. Recommended: limitation of heavy physical activity for two months (8 weeks).

Examination 3 months (12 weeks) after surgery: no complaints, the mammary glands are symmetrical, no edema, palpation soft. Postoperative scars are normotrophic. Recommended: lead a normal lifestyle.

Inspection after 1 year: no complaints. The mammary glands are symmetrical, soft. Ultrasound: no features.

The proposed method allows to exclude capsular contracture due to the fact that ozone has antibacterial and antifungal effects, normalizes tissue immunity. At the same time, the factors causing the formation of capsular contracture are minor chronic inflammation caused by a reaction to a foreign body, manifested by the activation of myofibroblasts, infection and hematoma.

Claims (1)

A method for preventing the formation of capsular contracture, including endoprosthetics of the mammary glands, characterized in that intraoperatively after creating a bed for prostheses on both sides, under m. pectoralis major, the bed is irrigated with ozonized saline solution with an ozone concentration of 2-4 mg / L.

Images