title: Never say no to a damaged muscle: the applications of previously damaged pectoralis major and latissimus dorsi muscles for chest wall reconstruction.
abstract: The nondamaged latissimus dorsi and pectoralis major muscles are widely reported in the literature as being the most frequently used for chest wall reconstruction. In this study, we report a series of 9 patients with full-thickness chest wall defects who underwent reconstruction with previously damaged latissimus dorsi or pectoralis major muscles. Nine patients underwent chest wall reconstruction over a period of 3 years using previously damaged latissimus dorsi or pectoralis major muscles. The thoracic defect was posttraumatic in 3 patients and post-tumor resection in 6 patients. Three patients had previous radiation therapy. In 8 cases, the full-thickness chest wall defects were completely closed. The only failure encountered was in one patient who had a long lasting fistula. The proximal based island flap that was inserted into the tract showed good vascular supply and viability; however, it did not solve the clinical problem. Keeping in mind the basic rule of medicine ("Primum Non Nocere") and a thorough knowledge of the surgical anatomy of these muscles are essential for the successful application of these previously damaged muscles for chest wall reconstruction.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Rambam Medical Center, Haifa, Israel. rmoscona@zahav.net.il
authors.forename: Rony A
authors.initials: RA
authors.lastname: Moscona
authors.forename: Lucian
authors.initials: L
authors.lastname: Fodor
authors.forename: Alon
authors.initials: A
authors.lastname: Ben-Nun
authors.forename: Lael Anson
authors.initials: LA
authors.lastname: Best
mesh_terms: D006801:Humans; D018482:Muscle, Skeletal / Q000601:surgery*; D010369:Pectoralis Muscles / Q000293:injuries / Q000601:surgery; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D013898:Thoracic Injuries / Q000601:surgery; D013899:Thoracic Neoplasms / Q000601:surgery; D035441:Thoracic Wall / Q000601:surgery*