Clinical Experiences of The Chest Wall Reconstructions.
- Author:
Soo Chul KIM
1
;
Sang Hoon PARK
;
Sang Hoon HAN
;
Taik Jong LEE
;
Dong Kwan KIM
Author Information
1. Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- MeSH:
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*
- From:Journal of the Korean Society of Plastic and Reconstructive Surgeons
1999;26(1):162-168
- CountryRepublic of Korea
- Language:Korean
-
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.
