Zhao Ru, Zeng Ang, Bai Ming, Qiao Qun
Department of Plastic Surgery, Beijing Union Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100032, China.
Zhonghua Zheng Xing Wai Ke Za Zhi. 2010 Sep;26(5):357-9.
To introduce the management of large chest wall defect.
From Oct. 2005 to Jun. 2009, 6 patients with large chest wall defects were reconstructed by latissimus dorsi muscle flap and titanium mesh in one case, reverse latissimus dorsi muscle flap and polypropylene mesh in one case, free lateral anterior thigh flap in one case, bilateral pectoralis muscle flap in one case, and vertical rectum abdominal muscle flaps in two cases.
The patients were followed up for 1-24 months with good cosmetic and functional results. The flaps survived completely. One case of chest wall fistula and one case of sinus occurred, which healed after debridement.
Every layers of chest wall defects should be reconstructed, respectively. The chest wall defects should be reconstructed by titanium mesh and polypropylene mesh first. The soft tissue defect should be covered with different flaps according to the location, area and the degree of the defects. Latissimus dorsi muscle flap can be as the first-line treatment with the advantages of good blood supply, flexible movement and abundant tissue volume.
