title: An alternative technique for anterior chest wall reconstruction: the sternal allograft transplantation.
abstract: OBJECTIVE
  Sternal resection is indicated for a variety of pathological conditions, mainly neoplastic or related to sternotomy complications. Resection of the sternum generally leaves a large chest-wall defect, and reconstruction is thus the most difficult part of the operation. Correct stabilization of the anterior chest wall is very important to avoid secondary complications and respiratory failure. In the last few years, different technical solutions have been used to reconstruct the sternum. We describe our technique using a sternal allograft to reconstruct the anterior chest wall after partial or complete sternal resection.
  
  
  METHODS
  Between June 2010 and February 2012, four patients underwent sternectomy followed by anterior chest wall reconstruction using sternal allograft. The sternal allograft was harvested from a multitissue donor following Italian legislation for tissue donation. Three patients had neoplastic involvement of the sternum, and one had a complete sternal defect as a complication of a cardiac operation.
  
  
  RESULTS
  We had no operative mortality. Three patients underwent partial sternal transplantation, and one underwent total sternal replacement. We had no postoperative respiratory insufficiency, infections or mechanical failure of the reconstructions. The respiratory function was preserved in all patients. The follow-up period was free from complications related to the sternal allograft implantation.
  
  
  CONCLUSIONS
  The technique of sternal allograft transplantation is simple, reproducible and provides excellent functional and cosmetic results. Further studies including a larger number of patients are needed to understand the biology of the allograft and the long-term results of this technique.
authors.affiliation: Thoracic Surgery Unit, S. Orsola-Malpighi University Hospital, Bologna, Italy. dellamore76@libero.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Dell'Amore
authors.forename: Nicola
authors.initials: N
authors.lastname: Cassanelli
authors.forename: Giampiero
authors.initials: G
authors.lastname: Dolci
authors.forename: Franco
authors.initials: F
authors.lastname: Stella
mesh_terms: D000328:Adult; D000368:Aged; D016025:Bone Transplantation / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000009:adverse effects; D056346:Sternotomy; D013249:Sternum / Q000637:transplantation*; D014184:Transplantation, Homologous; D016896:Treatment Outcome