Quality of the capsule in reconstructions with textured or smooth silicone implants after mastectomy.

Many women desire some kind of reconstruction after mastectomy for breast cancer to improve the cosmetic result. Since the introduction of silicone breast implants, capsular contracture has been the most common complication of breast augmentation or reconstruction. The aim of the present study was to evaluate the capsule quality in patients with breast cancer who had undergone reconstructions with either textured (rough) or smooth silicone implants after simple or modified radical mastectomy. Forty-three consecutive patients had reconstructions with textured silicone implants (49 implants) and were evaluated 32 months post-operatively in a prospective clinical trial. The last 43 consecutive patients who had reconstructions with bilumen smooth silicone implants (49 implants) acted as controls. The results were graded by Baker's classification. Among the patients with textured implants only 9% (4/47) was graded as having moderate or severe capsular contracture in contrast to 24% (11/46) in patients with bilumen smooth-surface implants (p < 0.05). These results confirm previous reports that favour textured silicone implants in breast augmentation and reconstruction.

[Extravasation of cytostatic agents--what is a good treatment?]. / Ekstravasering av cytostatika--hva er god behandling?

Extravasation of vesicant antitumour agents is a feared complication within oncologic therapy. The treatment is often meant to give palliation. Should extravasation occur it might further spoil the limited time many of these patients have left to live. The question is how to treat an extravasation injury without giving the patient an additional problem. The aim must be to remove the vesicant as soon as possible in a way that implies minimum morbidity and loss of function. At the Norwegian Radium Hospital, oncologists and plastic surgeons have cooperated on early surgical intervention, with good results. In our opinion, the problem arises when treatment is delayed. We present a retrospective study of 19 patients operated at the Norwegian Radium Hospital between 1986 and 1994, and discuss current methods of treatment.