Sıçan Modelinde Periprostetik Meme Kapsülünü Azaltmak İçin Profilaktik Zafirlukast, Montelukast Ve Kromolin Sodyum Tedavisi Uygulanması
Menku Ozdemir, Fethiye Damla
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Capsule contracture is a pathological condition caused by excessive fibrosis response to the breast implant. The mast cell is one of the key cells that stimulates this response with its proinflammatory mediators including but not limited to leukotriens, heparin, renin and histamin. Interruption of release of mast cell proinflammatory mediators is the basis for capsular contracture prophylaxis, although a precise prophylaxis scheme has not yet been defined. We hypothesized that cromolyn sodium, which is a mast cell membrane stabilizer, would prevent capsular contracture more effectively than leukotriene receptor antagonists histopathologically. In order to test this hypothesis an established rat implant model was used. Thirty rats were randomly divided into five groups containing six rats in each group. The rats in the control group received no intraperitoneal injections. The rats in the 0.9% physiological saline, cromolyn sodium, montelukast and zafirlukast groups received intraperitoneal injections. At the end of the fourth week, a smooth- surfaced round breast implant was inserted into the subpanniculus carnosus plane of each rat with a 2 cm incision at the level of the iliac bone. The rats were euthanized after 16 weeks of follow-up. Histopathologically, acute inflammation, inflammation severity, synovial metaplasia, giant cell reaction, mast cell count and capsule thickness were investigated. The mean number of mast cells, the mean capsule thickness and the mean inflammation severity were significantly the lowest and synovial metaplasia was found to be the highest in cromolyn sodium group. Cromolyn sodium was significantly more effective than saline, montelukast and zafirlukast in capsule contracture prophylaxis probably because of inhibition of release of proinflammatory mediators from the mast cell causing fibrosis.