title: An innovative method of pediatric chest wall reconstruction using Surgisis and swinging rib technique.
abstract: OBJECTIVE
  Herein, we describe a new surgical approach for chest wall reconstruction using a native supporting rib and Surgisis.
  
  
  METHODS
  A retrospective review of 3 cases from 2 tertiary pediatric health care centers presenting with chest wall defects in the neonatal period was performed. Perioperative data were collected.
  
  
  RESULTS
  Two chest wall deformities were diagnosed at birth (Poland syndrome and cleft sternum). One patient was diagnosed prenatally with a mediastinal mass. The first infant had absent ribs 2 through 9. He underwent chest wall reconstruction at 4 weeks of life because of difficulty weaning from ventilation related to paradoxical breathing. The hamartoma of the second asymptomatic patient was removed at 6 weeks. The third patient's V-shaped sternal defect encompassed through the upper two thirds of the sternum and was repaired at 6 months of age with intraoperative transesophageal echocardiogram monitoring. In all cases, Surgisis (collagen matrix) was used as an onlay patch. In 2 cases, a swinging rib acted supportive. Neither patient had intraoperative complications.
  
  
  CONCLUSIONS
  Surgisis is useful in pediatric chest wall reconstruction, particularly in combination with swinging ribs. The capacity for adaptation to the child's growth of this approach is crucial. Short-term safety is shown, but long-term assessment is required.
authors.affiliation: The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Carol
authors.initials: C
authors.lastname: Oliveira
authors.forename: Mohammed
authors.initials: M
authors.lastname: Zamakhshary
authors.forename: Tariq
authors.initials: T
authors.lastname: Alfadda
authors.forename: Fahad
authors.initials: F
authors.lastname: Alhabshan
authors.forename: Hisham
authors.initials: H
authors.lastname: Alshalaan
authors.forename: Stephen
authors.initials: S
authors.lastname: Miller
authors.forename: Peter C W
authors.initials: PC
authors.lastname: Kim
mesh_terms: D001672:Biocompatible Materials; D003094:Collagen; D005260:Female; D006222:Hamartoma / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008477:Mediastinal Diseases / Q000601:surgery; D019637:Orthopedic Procedures / Q000295:instrumentation / Q000379:methods*; D011045:Poland Syndrome / Q000601:surgery; D012189:Retrospective Studies; D012272:Ribs / Q000601:surgery*; D013249:Sternum / Q000002:abnormalities / Q000601:surgery; D035441:Thoracic Wall / Q000002:abnormalities / Q000601:surgery*; D054457:Tissue Scaffolds; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials; D003094:Collagen