The role of microsurgery in reconstruction of oncologic chest wall defects. Academic Article uri icon

Overview

abstract

  • Regional pedicled myocutaneous flaps are usually the best choice for soft-tissue coverage of full-thickness chest wall defects. As defects increase in size, microsurgical techniques are necessary to augment blood flow to pedicled flaps or to provide free flap coverage from distant sites. This study retrospectively reviews all microsurgical procedures performed at one institution for the coverage of full-thickness chest wall defects. Twenty-five cases of full-thickness chest wall reconstruction are reviewed. There were 20 free flaps and five supercharged pedicled flaps. A rectus abdominis myocutaneous flap (free or supercharged) was used in 20 cases, and a filet free flap following forequarter amputation was used in five patients. Large skeletal defects were repaired with a Marlex mesh/methylmethacrylate sandwich prosthesis. There was 100 percent flap survival and one case of minor, partial flap loss. The prosthesis remained effectively covered in all cases. Five patients required ventilatory support for up to 10 days postoperatively. There were three perioperative deaths due to multisystem failure. Microsurgical techniques are extremely useful for reconstruction of complicated, composite chest wall defects. They are indicated when regional pedicled flap options are unavailable or inadequate. These flaps have a 100 percent success rate and uniformly result in stable soft-tissue coverage.

publication date

  • December 1, 2001

Research

keywords

  • Plastic Surgery Procedures
  • Surgical Flaps
  • Thoracic Neoplasms

Identity

Scopus Document Identifier

  • 0035661872

Digital Object Identifier (DOI)

  • 10.1097/00006534-200112000-00012

PubMed ID

  • 11743378

Additional Document Info

volume

  • 108

issue

  • 7