Larson D L, McMurtrey M J, Howe H J, Irish C E
Cancer. 1982 Mar 15;49(6):1286-93. doi: 10.1002/1097-0142(19820315)49:6<1286::aid-cncr2820490635>3.0.co;2-t.
In the last year, 12 patients have undergone extensive chest wall resection. Eight patients had recurrent cancer after prior resection and irradiation with an average defect of 160 square centimeters, usually including ribs and a portion of the sternum; four had radionecrosis of soft tissue and/or bone. Methods of reconstruction included latissimus dorsi musculocutaneous (MC) flap (five patients), pectoralis major MC flap (seven patients), and omental flap and skin graft (one patient). The donor site was usually closed primarily. All flaps survived providing good wound coverage. The only complication was partial loss of a latissimus dorsi MC flap related to an infected wound; this reconstruction was salvaged with a pectoralis major MC flap. The hospital stay ranged from 10-25 days with a median stay of 11 days. Use of the MC flap is a valuable tool which can be used to significantly decrease morbidity, hospital stay, and patient discomfort related to the difficult problem of chest wall reconstruction after radiation therapy.
在过去一年中，12例患者接受了广泛的胸壁切除术。8例患者先前接受过切除和放疗后出现复发性癌症，平均缺损面积为160平方厘米，通常包括肋骨和部分胸骨；4例有软组织和/或骨放射性坏死。重建方法包括背阔肌肌皮瓣（5例）、胸大肌肌皮瓣（7例）、网膜瓣和植皮（1例）。供区通常一期关闭。所有皮瓣均存活，伤口覆盖良好。唯一的并发症是与感染伤口相关的背阔肌肌皮瓣部分坏死；采用胸大肌肌皮瓣挽救了此次重建。住院时间为10至25天，中位住院时间为11天。肌皮瓣的应用是一种有价值的工具，可显著降低与放疗后胸壁重建难题相关的发病率、住院时间和患者不适。
