The role of microsurgery in reconstruction of oncologic chest wall defects Journal Article


Authors: Cordeiro, P. G.; Santamaria, E.; Hidalgo, D.
Article Title: The role of microsurgery in reconstruction of oncologic chest wall defects
Abstract: Regional pedicled myocutaneous flaps are usually the best choice for soft-tissue coverage of full-thickness chest wall defects. As defects increase in size, microsurgical techniques are necessary to augment blood flow to pedicled flaps or to provide free flap coverage from distant sites. This study retrospectively reviews all microsurgical procedures performed at one institution for the coverage of full-thickness chest wall defects. Twenty-five cases of full-thickness chest wall reconstruction are reviewed. There were 20 free flaps and five supercharged pedicled flaps. A rectus abdominis myocutaneous flap (free or supercharged) was used in 20 cases, and a filet free flap following forequarter amputation was used in five patients. Large skeletal defects were repaired with a Marlex mesh/methylmethacrylate sandwich prosthesis. There was 100 percent flap survival and one case of minor, partial flap loss. The prosthesis remained effectively covered in all cases. Five patients required ventilatory support for up to 10 days postoperatively. There were three perioperative deaths due to multisystem failure. Microsurgical techniques are extremely useful for reconstruction of complicated, composite chest wall defects. They are indicated when regional pedicled flap options are unavailable or inadequate. These flaps have a 100 percent success rate and uniformly result in stable soft-tissue cove rage.
Keywords: free-flap
Journal Title: Plastic and Reconstructive Surgery
Volume: 108
Issue: 7
ISSN: 0032-1052
Publisher: Lippincott Williams & Wilkins  
Date Published: 2001-12-01
Start Page: 1924
End Page: 1930
Language: English
ACCESSION: WOS:000172735900012
DOI: 10.1097/00006534-200112000-00012
PROVIDER: wos
PUBMED: 11743378
Notes: Article -- Source: Wos
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  1. David A Hidalgo
    47 Hidalgo
  2. Peter G Cordeiro
    282 Cordeiro