Closure of massive chest wall defects after full-thickness chest wall resection.
We report an unusual repair of a massive chest wall defect resulting from resection of a chronic ulcer after radiation therapy for stage IV breast carcinoma. The defect was 690 cm2 and included the body of the sternum, 10 ribs, and the anterior portion of the diaphragm. Chest wall reconstruction was accomplished with multiple flaps: a pectoralis major advancement flap, a reversed abdominoplasty, an omental flap, and a latissimus dorsiscapular-parascapular musculofasciocutaneous (hemiback) flap. Skeletal reconstruction with prosthetic material or bone grafts was not performed in this patient. The problems associated with complex chest wall reconstructions are discussed.
Bury
T F
TF
Department of Reconstructive and Plastic Surgery, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
Reece
G P
GP
Janjan
N A
NA
McMurtrey
M J
MJ
D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy / Q000532:radiotherapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D011832:Radiation Injuries / Q000601:surgery*; D011882:Radiotherapy, High-Energy; D013524:Surgical Flaps / Q000379:methods*; D013896:Thoracic Diseases / Q000209:etiology / Q000601:surgery*; D013905:Thoracoplasty / Q000379:methods; D014456:Ulcer / Q000209:etiology / Q000601:surgery