Collagen and glycosaminoglycans in capsules around silicone implants

A Study of the Mass Transport Resistance of Glucose Across Rat Capsular Membranes

The interaction between a polymer or other foreign surface and soft tissue is determined by a variety of materials and tissue factors. After failing to engulf the foreign body, the classical response is to wall it off. First the site is invaded by macrophages and giant cells and then fibrous connective tissue is laid down. This fibrous connective tissue gradually replaces the cellular matrix and forms the capsule. The composition is mostly collagen and mucopolysaccharides with few cells in the mature capsule. It contains 75–80% water.

When the implant surface represents a sensor and the transport of low molecular weight species across the capsule is necessary for meaningful measurement and response time, the mass transport resistance of the capsule may become a critical factor. This study represents an initial attempt to characterize the diffusion of glucose through fibrous capsules grown around silicone elastomer implants in a rat. Specifically, the study was designed to develop techniques to measure mass transport properties of tissue capsules, to use these techniques to determine effective glucose transport properties at two weeks, four weeks, and ten weeks after implant; and, to use these results along with histological examinations to gain an understanding of the factors which influence mass transport.

Immunolocalization of keratan sulfate, chondroitin-4-sulfate, and chondroitin-6-sulfate in periprosthetic breast capsules exhibiting synovial metaplasia

The distribution of various proteoglycans and basement membrane components within 10 breast capsules with synovial metaplasia was assessed immunohistochemically. Immunoreactive keratan sulfate and chondroitin-4-sulfate were present in many of the synovial metaplasia lining cells, suggesting active secretion of these proteoglycans into the intraprosthetic space. In contrast, chondroitin-6-sulfate was confined to the extracellular matrix of the underlying supporting fibrous capsule. Type IV collagen and laminin were not associated with the synovial metaplasia lining, thus confirming the absence of a basement membrane, as previously indicated by morphologic analysis. As with tendon reconstruction, the development and maintenance of a synovial metaplasia lining that secretes lubricating factors such as proteoglycans may be beneficial for decreased capsular contracture.

Breast capsule contracture: is fibroblast activity associated with severity?

Factors responsible for breast capsule contracture remain elusive. Using an in vitro model of wound contraction, the fibroblast-populated collagen lattice (FPCL), breast capsule fibroblasts and control dermal fibroblasts from ten patients were analyzed. Comparison was made to determine (1) if the activity of dermal fibroblasts on a collagen lattice correlated with the activity of breast capsule fibroblasts or if capsular fibroblasts are unique, and (2) if the degree of fibroblast-driven collagen contraction correlated with clinical severity of breast capsule contracture. If so, a preoperative predictor of breast capsule contracture would be available. Dermal fibroblasts and breast capsule fibroblasts were cultured and mixed with media and collagen to form a matrix, and then the degree of lattice contraction was measured. A correlation between breast capsule fibroblasts and control dermal fibroblasts with respect to collagen matrix contraction was confirmed. Collagen lattice contraction coordinated by fibroblasts derived from breast capsules did not correlate with clinical severity of capsular contracture. These results indicate that the degree of breast capsule contracture can not be predicted by fibroblast activity alone. An interaction between inflammatory cells, extracellular matrix, and fibroblasts is hypothesized. Further work is needed to delineate the mechanisms responsible for breast capsule contracture.

Morphological study of the capsular organization around tissue expanders coated with N-carboxybutyl chitosan

Expanders coated with N-carboxybutyl chitosan were inserted into surgical wounds in the dorsal skin of rabbits and the formation of capsular tissue was studied by scanning electron microscopy and transmission electron microscopy. N-carboxybutyl chitosan, in the course of the capsular organization, favours and potentiates the correct proliferation and organization of the tissue, rather than sustaining reactive processes leading to scar formation. N-carboxybutyl chitosan stimulates physiologically the tissue repair process and favours angiogenesis, whilst depressing fibrogenesis to a certain extent. Applications are envisaged in the treatment of wounds and in plastic surgery.

Biochemical characterization of connective tissue reaction to synthetic polymer implants

The present review is concerned with the significance and prospects of the use of biochemical methods to characterize connective tissue reaction to implanted synthetic polymer materials. The necessity of carrying out complex quantitative analysis of capsules developing around the implants in order to elucidate qualitative peculiarities of the reaction and to objectify the assessment of the reactogeneity of the material is emphasized.

Development of topical BAPN delivery system for acute spinal cord injury in dogs

Topical sustained release of various medications by a subdurally implantable device at the site of spinal cord injury is considered advantageous in the treatment of early symptoms of tissue damage. A typical case is the interference with collagenous scar by beta-aminopropionitrile, inhibiting collagen polymerization. Four materials, silicone, polyethylene, polytetrafluoroethylene (PTFE), and polyacrylonitrile-based hydrogel were evaluated for biocompatibility in subcutaneous implantations. The hydrogel, the least reactive, was then compared with silicone sheets as subcural implants. The histology favored the hydrogel as the most inert material, which was then used for the construction of soft, pliable pouches, releasing the drug through the hydrated wall at a rate controlled by an osmotic pump.