Comparison of mersilene mesh-methyl metacrylate sandwich and polytetrafluoroethylene grafts for chest wall reconstruction.
We report the outcomes of patients who underwent reconstruction with Mersilene mesh-methyl methacrylate (MM-MM) sandwich and polytetrafluoroethylene (PTFE) grafts after a large chest wall resection. Between June 1990 and September 2001, 59 consecutive patients (37 men, 22 women; mean age, 48.1 +/- 11.8 years; range 22-74 years) underwent large chest wall resection (greater than 5 cm diameter) and reconstruction with prosthetic material in our department. Twenty-one patients (33%) underwent reconstruction with a PTFE graft (group 2) between 1990 and 1994, and 38 patients (67%) underwent reconstruction with an MM-MM sandwich graft (group 1) between 1994 and 2001. Operative morbidity ratios were 5.2% (2/38) in group 1 and 24% (5/21) in group 2 (p = .036). The paradoxical respiration ratio was significantly higher (p = .018) in group 2 (5/21: 24%) than it was in group 1 (1/38: 2.6%). The operative mortality ratio was 4.5% (1/21) in group 2 and 0% in group 1. Mean hospital stay was 10.6 days (range 5-21 days) in group 1 and 13.3 days (range 7-36 days) in group 2 (p = .015). The MM-MM graft is inexpensive and easy to apply, provides better cosmetic options, and offers minimal morbidity. We therefore recommend that the MM-MM sandwich graft be used rather than the PTFE graft for large defects of the anterolateral chest wall and sternum where successful prevention of paradoxical respiration is required.
Kilic
Dalokay
D
Department of Thoracic Surgery, School of Medicine, Baskent University Hospital, Baskent University, Adana, Turkey. dalokay7@yahoo.com
Gungor
Adem
A
Kavukcu
Sevket
S
Okten
Ilker
I
Ozdemir
Nezih
N
Akal
Murat
M
Yavuzer
Sinasi
S
Akay
Hadi
H
D000328:Adult; D000368:Aged; D001705:Bioprosthesis / Q000009:adverse effects / Q000191:economics; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D020366:Methylmethacrylate; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications / Q000401:mortality; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D013526:Surgical Mesh / Q000009:adverse effects / Q000191:economics; D035441:Thoracic Wall / Q000601:surgery*; D016896:Treatment Outcome
D011093:Polyethylene Terephthalates; D020366:Methylmethacrylate; C025539:Lavsan; D011138:Polytetrafluoroethylene