In this thesis work, the current and innovative approaches for breast reconstruction after cancer have been studied. In the first chapter, an overview of synthetic breast implants was carried out, describing the current surgical approaches and the approaches involving the use of autologous tissue flaps, reporting advantages and disadvantages. The main problems related to the implantation of a synthetic prosthesis were then reported, focusing on infection, Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) and capsular contracture. Subsequently, the prosthetic materials for the shell (cross-linked silicone elastomer) and for the filling (saline solution or silicone gel) were introduced, reporting the main advantages and disadvantages. Subsequently, the surface characteristics of the prostheses (smooth, textured) were described and advantages and disadvantages were reported. The second chapter described the adjuvant use of biological and synthetic membranes in the prosthesis and reported the advantages and disadvantages of their use. In the third chapter, the approaches of reparative medicine that aim to make the surface of the prosthesis shell more biocompatible were studied. Examples of materials under research have been reported and some studies have been described (styrene-butadiene copolymer, silk fibroin, methacryloyloxyethyl-phosphorylcholine) reporting the results. Finally, an example of a material in clinical use and its application in a specific prosthesis (Microthane, Polytech) was reported. In the fourth chapter the innovative approaches in the field of regenerative medicine and tissue engineering were reported. Requirements for a material for adipose tissue engineering have been defined, the use of cross-linked gelatin as a scaffold has been reported; the example of a synthetic material (polycaprolactone) for the construction of scaffolds has been reported and examples of "bioprostheses" (Senella, BellaSeno; Mattisse, Lattice Medical; UR-shape, Healshape) close to the commercialization phase have been reported. In the fifth chapter the conclusions regarding what is described in the present thesis have been drawn.
Nel presente elaborato di tesi sono stati approfonditi gli approcci attuali e innovativi per la ricostruzione mammaria in seguito a tumore. Nel primo capitolo è stata effettuata una panoramica sulle protesi mammarie sintetiche, descrivendo gli approcci chirurgici attuali e gli approcci che prevedono l’utilizzo di lembi tessutali autologhi riportando vantaggi e svantaggi. Sono state poi riportate le maggiori problematiche relative all’impianto di una protesi sintetica focalizzandosi su infezione, Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) e contrattura capsulare. In seguito, sono stati introdotti i materiali protesici con cui vengono realizzati il guscio (elastomero siliconico reticolato) e il riempimento (soluzione salina o gel di silicone) riportando i principali vantaggi e svantaggi. Successivamente, sono state descritte le caratteristiche superficiali delle protesi (lisce, texturizzate) e sono stati riportati vantaggi e svantaggi. Nel secondo capitolo è stato descritto l’impiego coadiuvante alla protesi di membrane biologiche e sintetiche e sono stati riportati vantaggi e svantaggi del loro utilizzo. Nel terzo capitolo sono stati approfonditi gli approcci di medicina riparativa che mirano a rendere la superficie del guscio della protesi maggiormente biocompatibile. Sono stati riportati esempi di materiali in fase di ricerca e sono stati descritti alcuni studi (copolimero stirene-butadiene, fibroina della seta, metacriossietile-fosforilcolina) riportandone i risultati. Infine, è stato riportato un esempio di materiale in uso clinico e la sua applicazione in una protesi specifica (Microthane, Polytech). Nel quarto capitolo sono stati riportati gli approcci innovativi in ambito di medicina rigenerativa e dell’ingegneria dei tessuti. Sono stati definiti i requisiti per un materiale per l’ingegneria del tessuto adiposo, è stato riportato l’impiego della gelatina reticolata come scaffold; è stato riportato l’esempio di un materiale sintetico biodegradabile (policaprolattone) per la realizzazione di scaffold e sono stati riportati esempi di “bioprotesi” (Senella, BellaSeno; Mattisse, Lattice Medical; UR-shape, Healshape) vicine alla fase di commercializzazione. Nel quinto capitolo sono state tratte le conclusioni in merito a quanto descritto nel presente elaborato.
Strategie per la rigenerazione del tessuto in seguito ad intervento di mastectomia
Melzi, Erica
2022/2023
Abstract
In this thesis work, the current and innovative approaches for breast reconstruction after cancer have been studied. In the first chapter, an overview of synthetic breast implants was carried out, describing the current surgical approaches and the approaches involving the use of autologous tissue flaps, reporting advantages and disadvantages. The main problems related to the implantation of a synthetic prosthesis were then reported, focusing on infection, Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) and capsular contracture. Subsequently, the prosthetic materials for the shell (cross-linked silicone elastomer) and for the filling (saline solution or silicone gel) were introduced, reporting the main advantages and disadvantages. Subsequently, the surface characteristics of the prostheses (smooth, textured) were described and advantages and disadvantages were reported. The second chapter described the adjuvant use of biological and synthetic membranes in the prosthesis and reported the advantages and disadvantages of their use. In the third chapter, the approaches of reparative medicine that aim to make the surface of the prosthesis shell more biocompatible were studied. Examples of materials under research have been reported and some studies have been described (styrene-butadiene copolymer, silk fibroin, methacryloyloxyethyl-phosphorylcholine) reporting the results. Finally, an example of a material in clinical use and its application in a specific prosthesis (Microthane, Polytech) was reported. In the fourth chapter the innovative approaches in the field of regenerative medicine and tissue engineering were reported. Requirements for a material for adipose tissue engineering have been defined, the use of cross-linked gelatin as a scaffold has been reported; the example of a synthetic material (polycaprolactone) for the construction of scaffolds has been reported and examples of "bioprostheses" (Senella, BellaSeno; Mattisse, Lattice Medical; UR-shape, Healshape) close to the commercialization phase have been reported. In the fifth chapter the conclusions regarding what is described in the present thesis have been drawn.| File | Dimensione | Formato | |
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https://hdl.handle.net/10589/198792