Reconstruction of the chest wall after full thickness resection: a comparison between myocutaneous flap and acrylic resin plate as reconstructive techniques.

Thirty-three patients with chest wall malignancies underwent full thickness resection of the chest wall and immediate reconstruction of the defects with either synthetic materials (acrylic resin plate, 16 patients) or with myocutaneous flaps (rectus abdominis flaps, 17 patients). Although the acrylic resin plate proved to be excellent for maintaining stability of the chest wall, five patients suffered from local skin necrosis, requiring skin grafting, and four suffered from persistent foreign body reactions, necessitating ultimate removal of the plate. The patients receiving myocutaneous flap repair had excellent wound healing, acceptable rigidity of their chest wall, and no foreign body reactions throughout the follow-up period. The 50% post-operative survival time for the entire series was 29 months, suggesting that the procedure in an effective treatment modality for breast cancer involving the chest wall. Reconstruction with a myocutaneous flap is indicated as long as the chest wall defect is not too extensive.