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The Annals of Thoracic Surgery, Vol 27, 440-444, Copyright © 1979 by The Society of Thoracic Surgeons
SG Hubbard, EP Todd, W Carter, J Zeok, ML Dillon and E Luce
This report summarizes our experience during a four-year period with the
repair of 8 thoracic cage and 3 diaphragmatic defects requiring
reinforcement with prosthetic material. Defects as large as the entire left
hemidiaphragm or the right anterior chest wall including ribs two through
six from the midsternum to the midaxillary line were adequately repaired.
The technical approach utilized to obtain a secure, nonmobile thoracic cage
involved the placement of sutures through drill holes or around ribs,
rather than through the periosteum or pericostal soft tissues. Successful
diaphragmatic repair was dependent on proper anchoring of the medial border
of the prosthesis, placing sutures in the pericardium as necessary. Skin
coverage for thoracic cage defects was achieved with widely undermined and
advanced local tissue or previously delayed pedicle flaps. All patients had
good evidence of chest wall stabilization after operation, and all were
removed from mechanical ventilation within three days. One patient died of
myocardial infarction twenty days after operation, and a second patient
died later of metastatic disease. On the basis of our experience, we
conclude that the range of chest wall lesions that can be surgically
corrected or palliated is increased by the use of prosthetics implanted
with techniques described here.
ARTICLES
Repair of chest wall defects with prosthetic material
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