Combined free vascularized iliac osteocutaneous flap and pedicled pectoralis major myocutaneous flap for reconstruction of anterior chest wall full-thickness defect.
Large defects of the anterior chest wall lead to gross chest instability that can result in paradoxic respiration. Osteoradionecrosis of the lower sternum and multiple left ribs resulted in a huge, full-thickness defect of the left anterior chest wall in a 67-year-old woman. An iliac osteocutaneous flap (bone segment 3 × 14 cm) was harvested for reconstruction of the bone defect. The skin defect was covered by the skin paddle of the iliac osteocutaneous flap and a contralateral rotational pectoralis major muscle flap. Months postoperatively, the patient was physically active, the chest was stable, and the vascularized iliac bone was incorporated into the recipient bone.
Department of Plastic Surgery, Mackay Memorial Hospital, Taipei, Taiwan, Republic of China. prschang@yahoo.com.tw
Shih-Hsin
SH
Chang
Kwang-Yi
KY
Tung
Hung-Tao
HT
Hsiao
Chiao-Hung
CH
Chen
Hou-Keng
HK
Liu
D000368:Aged; D001847:Bone Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D001943:Breast Neoplasms / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D008408:Mastectomy / Q000009:adverse effects; D010025:Osteoradionecrosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D012272:Ribs / Q000473:pathology / Q000601:surgery*; D012883:Skin Ulcer / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D013249:Sternum / Q000473:pathology / Q000601:surgery*; D019616:Thoracic Surgical Procedures / Q000379:methods*; D035441:Thoracic Wall / Q000473:pathology / Q000601:surgery