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The Annals of Thoracic Surgery, Vol 46, 508-512, Copyright © 1988 by The Society of Thoracic Surgeons
RJ McKenna Jr, CF Mountain, MJ McMurtrey, D Larson and QR Stiles
Myocutaneous flaps and prosthetic materials have greatly facilitated
reconstruction after massive chest wall resection. This series includes 112
such procedures. Latissimus dorsi, rectus abdominis, omental, pectoralis
major, and contralateral breast flaps were used in 80 patients. Early in
the series, 3 flaps were lost because of technical problems. Minor areas of
incomplete healing that resolved completely with local wound care occurred
in 16 of 80 flaps. Skeletal reconstruction was performed in 82 patients
without complication. Marlex mesh was used for flat surfaces, and Marlex
mesh with methyl methacrylate was used for the sternum and the curved
surface of the lateral chest wall. These results have allowed an expansion
of the indications for chest wall resection to include the curative
treatment of primary chest wall tumors and palliative treatment for breast
cancer patients with osteoradionecrosis, local recurrence (in select
patients), chest wall infection, and tumors metastatic to the chest wall.
ARTICLES
Current techniques for chest wall reconstruction: expanded possibilities for treatment
Department of Thoracic Surgery, University of Texas M. D. Anderson Hospital and Tumor Institute, Houston 77030.
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