The use of biological implants for soft tissue and chest wall reconstruction in thoracic surgery is safe even in contaminated environments

Plastic surgeons are typically called upon to reconstruct the chest wall in four situations: oncologic resection, infections, trauma and osteoradionecrosis. In this chapter we will discuss post-oncologic reconstruction. Chest wall reconstruction following tumor resection is typically performed at the same setting as the ablative surgery; this results in quicker patient recovery and overall better outcomes. The reconstruction should be planned with the ablative surgeon so that an assessment can be made of the extent of resection and available donor sites for reconstruction. The major components of reconstruction are 1) skeletal support and 2) soft tissue coverage. Skeletal support is indicated if the defect is >5 cm, 4 or more ribs are removed or more than 2/3rd of the sternum is resected. Prosthetic mesh is most commonly used. Soft tissue reconstruction is performed with regional pedicled flaps in the vast majority of cases. Free flaps are used when regional flaps are not sufficient (large defects) or not available. This review contains 11 figures, 3 tables, and 49 references. Keywords: chest wall, tumor, skeletal reconstruction, soft tissue reconstruction, mesh, acellular dermal matrix, titanium osteosynthesis systems, resorbable plates, pedicled flaps, free flaps

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Results of Bony Chest Wall Reconstruction with Expanded Polytetrafluoroethylene Soft Tissue Patch

Annals of Thoracic and Cardiovascular Surgery ◽

10.5761/atcs.oa.14-00195 ◽

2015 ◽

Vol 21 (2) ◽

pp. 119-124 ◽

Cited By ~ 3

Author(s):

Haibo Huang ◽

Kentaro Kitano ◽

Kazuhiro Nagayama ◽

Jun-ichi Nitadori ◽

Masaki Anraku ◽

...

Keyword(s):

Soft Tissue ◽

Chest Wall ◽

Chest Wall Reconstruction ◽

Expanded Polytetrafluoroethylene

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Use of pedicled latissimus dorsi flap in anterior chest wall reconstruction

BMJ Case Reports ◽

10.1136/bcr-2020-239890 ◽

2021 ◽

Vol 14 (1) ◽

pp. e239890

Author(s):

Rini Vyas ◽

Rebecca Rollett ◽

Nakul Patel ◽

Sridhar Rathinam

Keyword(s):

Soft Tissue ◽

Chest Wall ◽

Latissimus Dorsi ◽

Anterior Chest Wall ◽

Chest Wall Reconstruction ◽

Latissimus Dorsi Flap ◽

Chest Wall Resection ◽

Soft Tissue Reconstruction ◽

Form And Function ◽

Tissue Reconstruction

Successful surgical management of chest wall tumours relies on extensive chest wall resection with adequate margins. In large complex tumours, return to form and function is determined by appropriate skeletal and soft tissue reconstruction of the chest wall defect. We report an original case of a large 11×16×3 cm ulcerative basosquamous carcinoma of the anterior chest wall. Soft tissue reconstruction was performed with a unilateral pedicled latissimus dorsi flap. A multidisciplinary approach between thoracic and plastic surgeons was used in the planning, intraoperative and follow-up periods. This case highlights a good long-term functional and cosmetic outcome in complex chest wall reconstruction as a result of successful cross-specialty collaboration.

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