Strength of silicone breast implants.

Rupture and leakage are recognized problems associated with silicone breast implants. Data are scarce about the durability of the silicone shell, and the life span of this device is unknown. The purpose of this study was to investigate the strength of silicone breast implants. Thirty implant shells were subjected to mechanical testing. Twenty-nine of the shells were tested after explanation, and one unused implant served as a control to validate the testing method. Implantation time varied from 4 months to 20 years, and all shells were tested, regardless of condition. Fourteen implant shells were intact, eight were leaking, and seven were ruptured. All ruptured implants had been in place for 10 years or longer. The breaking force of all excised shell specimens ranged from 2.6 to 22.4 N (0.6 to 5.0 lb.). Specimens from the control "high performance" shell required 15.5 to 25.6 N (3.5 to 5.8 lb) of force to fail. The weakest group was from thin-shelled implants between 10 and 16 years of age. More than half these specimens failed with less than 1 lb of force. The average breaking force of ruptured shell material was less than that of intact shells. A comparison of strength data in this study with manufacturers' data suggests that breaking force is dependent on implant type, shell thickness, and implantation time.

Rupture and aging of silicone gel breast implants.

This retrospective study evaluated aging and rupture of silicone gel breast implants in 31 women. The implants were removed at a large multispecialty clinic from 1987 to 1990. The implants ranged in age from 1 to 17 years. Of the 51 implants removed, 27 were ruptured, 7 were leaking, and 17 were in good condition. Common reasons for implant removal were discomfort, firmness, or a mass adjacent to a ruptured implant. Injury to the breast (trauma or mammography) led to a removal in only 4 patients. Closed capsulotomies were common in both ruptured and intact groups. The number of intact implants declined over time. All implants older than 10 years were leaking or ruptured. There was a positive correlation between the duration of implantation time and the number of ruptured and leaking implants.

Athletic facial injuries.

Most facial injuries that occur during athletic activities are of a minor nature, consisting of lacerations, contusions, and abrasions. These are usually treated by a team physician or an emergency department physician. However, minor injuries must be differentiated from the more significant injuries, especially those involving facial bone fractures. Significant facial trauma must be diagnosed accurately and treated with precision to avoid permanent facial deformity. Soft-tissue trauma as well as fractures are included in this review, and evaluation of the injured athlete is emphasized. A systematic approach is developed for diagnosing and treating common facial injuries in athletes.

Ultrastructural aspects of cooled thermal injury.

This study reports on the effects of early cooling on the morphology of partial-thickness burns. After 10% body surface dorsal scald burns at 75 degrees C for 10 seconds, guinea pigs were treated by ice-water immersion at 10 minutes postburn of only the burned surface for 30 minutes. Skin samples from treated and untreated burn wounds were examined at 2, 8, 24, and 96 hours postburn by light and electron microscopy. During the first 24 hours, cooling was associated with reduced loss of epidermis and reduced damage to the basement membrane. There was also less damage to the dermal microvasculature and less edema fluid compared to untreated burn wounds. At 96 hours, the cooled burn wounds demonstrated minimal dermal hemorrhage and polymorphonuclear leukocytic infiltration, compared to the untreated wounds. These results indicate that on a cellular level, cooling has beneficial effects on the experimental burn wound.