Lysytsyn R. Complex Prophylaxis of Occurrence of Breasts Capsular Contracture (Clinical and Experimental Research).

The dissertation has clinically and experimentally character and is devoted an actual problem of modern plastic surgery - to increase of efficiency of aesthetic operations (augmentation mammaplasty) at the expense of the prevention of development of severity level of breasts capsular contracture by influence on process of formation of a capsule round silicone implant. Experimental, immunological and morphological researches, clinical supervision and radiologic inspection have allowed to consider features of formation of a capsule round established implants proceeding from structure of their surface and term of stay in an organism and to have an opportunity to influences on process of formation of a capsule. Efficiency of medicamentous prophylaxis of occurrence breast capsular contracture which is based on oppression to leukotriene receptor antagonist of chemotaxis of leukocytes in area of contact of a cover of silicone implant and surrounding tissues is clinically proved. Appointment of 10 mg Montelukast Sodium once a day within 6 weeks has given possibility to increase in 1,8 times of frequency of appearance of grade I contraction of fibrous capsule (р<0,01), decreases in 1,6 times formation of grade II constrictive fibrosis (р<0,05) and to prevent development of grades III-IV of breasts capsular contracture. The developed method of partial surgical immobilization of the pectoralis major muscle causes a temporary restriction of reductions of a muscle for time which is necessary for formation of fibrous capsule and preserves established prostheses against turn, thereby warning development of contraction of capsule. Association in a uniform complex of medicamentous prophylaxis with developed method has allowed to reach increases in 2,2 times relative density of grade I contraction of fibrous capsules (р<0,001), decrease in 3,2 times frequency of grade II contraction (р<0,001) at total absence grades III-IV of constrictive fibrosis and high stability of the formed capsules.