J Korean Soc Plast Reconstr Surg.  1999 Jan;26(1):162-168.

Clinical Experiences of The Chest Wall Reconstructions

• Kim SC
• Park SH
• Han SH
• Lee TJ
• Kim DK

Abstract

Reconstruction of chest wall defects has been a continuing challenge to surgeons. Defects due to resection of tumors, infection, radiation injuries, and congenital anomalies may require chest wall reconstruction. Recent advances in plastic surgery have made reconstruction of the chest wall a reliable procedure. We reviewed fourteen consecutive chest wall reconstructions except mediastinitis over the past eight years. Among the patients, ten patients had chest wall tumors and remaining four patients had radiation necrosis, pressure sore, Poland's syndrome and Tuberculous empyema. Skeletal resection of the chest wall was done in six patients; Total or partial stemectomies were performed in three patients and an average of three point six ribs were resected in six patients. Soft tissue resection was performed in twelve patients. After resection, the thoracic skeletal defect was reconstructed with polypropylene mesh (Marlex) alone in one patient, with a composite of polypropylene mesh (Marlex) and methyl metacrylate in two patients, and with autogenous ribs in one patient. Soft tissue reconstructive procedures were predominantly muscle transpositions: five pectoralis major, three latissimus dorsi,two rectus abdominis and three fasciocutaneous flaps. Eleven patients who were alive after operation have protective and functional chest wall with excellent cosmesis at the time of last follow-up. We conclude that chest wall reconstructive procedures with prosthetic, or autogenous materials and musculocutaneous flaps are safe, durable and contributive to long-term survival and quality of life.

MeSH Terms

Empyema, Tuberculous
Follow-Up Studies
Humans
Mediastinitis
Myocutaneous Flap
Necrosis
Polypropylenes
Pressure Ulcer
Quality of Life
Radiation Injuries
Rectus Abdominis
Ribs
Surgery, Plastic
Thoracic Wall*
Thorax*
Polypropylenes