[Reconstruction strategy in chest wall defect relating to the localization of the lost substances: retrospective study of 18 patients].
OBJECTIVE
To evaluate an original algorithm in function of the chest wall defect localization after large surgery for cancer including more than 3 ribs.


METHODS
Our retrospective study on 18 patients (10 women, 8 men), operated by the senior author, showed 8 pathological tumor localization in the central chest region, 7 in the lateral region and 3 borderline localizations. For central localizations, when the sternum was resected, the reconstruction was realized with a Gore-tex mesh in depth, metal hooks (staples) and Marlex mesh under the musculocutaneous superficial coverage flap. Lateral localizations was done by a Gore-tex mesh covered by the musculocutaneous flap; the borderline localizations were covered by a Marlex mesh and superficial musculocutaneous flap. The superficial coverage flaps were performed by latissimus dorsi flaps in 16 cases and transversus rectus abdominis flap in 2 cases.


RESULTS
All the patients were extubated and breathed spontaneously in the postoperative period. Two deaths and one infection were to regret at distance. No flap was lost.


CONCLUSIONS
The algorithm of reconstruction according to the location of the defect allows a simplification of the indications.
Coeugniet
E
E
Service de chirurgie plastique, CHU Lille, hôpital R. Salengro, France. e_coeugniet@hotmail.com
Danino
A
A
Malka
G
G
Revol
M
M
Servant
J M
JM
D000293:Adolescent; D000328:Adult; D000465:Algorithms; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D013526:Surgical Mesh; D013899:Thoracic Neoplasms / Q000601:surgery; D035441:Thoracic Wall / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome