title: Chest wall reconstruction using biomaterials.
abstract: BACKGROUND
  Skeletal chest wall reconstruction can be a challenge, depending on the indication, location, and health of the patient; various materials are available. Recently, biomaterials that are remodelable (bovine pericardium patch; Veritas, Synovis Life Technologies Inc, St Paul, MN) or absorbable (polylactic acid [PLA] bar; BioBridge, Acute Innovations, Hillsboro, OR) have been introduced for reconstruction procedures.
  
  
  METHODS
  We performed a retrospective review of all patients who underwent chest wall stabilization or reconstruction between July 1, 2009, and March 31, 2011.
  
  
  RESULTS
  Biomaterials were used in 25 of 112 patients (22%) who underwent chest wall stabilization or reconstruction, and they form the basis of this review. Indication for reconstruction was malignant disease in 17 patients (68%). Overall, 10 (40%) resection sites were infected preoperatively. Reconstruction was performed with a combination of bovine pericardium and PLA bars in 11 patients (44%), bovine pericardium alone in 10, and PLA bars alone in 4; muscle flaps were interposed in 7 patients (28%). There were no operative deaths. Complications occurred in 6 patients (24%). Median follow-up was 12 months (range, 6 to 27 months). Three patients required removal of their biomaterials. Two bovine pericardial patches were removed prophylactically at the time of debridement of a partially necrotic muscle flap, and 1 PLA bar was removed because of an inflammatory reaction. None of the patients with an infected resection site required removal of their biomaterial.
  
  
  CONCLUSIONS
  Chest wall reconstruction with biomaterials is a valuable option in the management of patients with chest wall abnormalities. Early results are promising. Biomaterials may be the preferred method of reconstruction for infected chest wall sites.
authors: Section of General Thoracic Surgery, Emory University School of Medicine, Atlanta, GA 30322, USA. daniel.miller@emoryhealthcare.org
authors: Daniel L
authors: DL
authors: Miller
authors: Seth D
authors: SD
authors: Force
authors: Allan
authors: A
authors: Pickens
authors: Felix G
authors: FG
authors: Fernandez
authors: Theresa
authors: T
authors: Luu
authors: Kamal A
authors: KA
authors: Mansour
mesh_terms: D000180:Acrylic Resins; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001672:Biocompatible Materials; D002417:Cattle; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000637:transplantation*; D012189:Retrospective Studies; D013524:Surgical Flaps; D013526:Surgical Mesh; D013899:Thoracic Neoplasms / Q000601:surgery; D019616:Thoracic Surgical Procedures / Q000379:methods*; D035441:Thoracic Wall / Q000601:surgery; D013905:Thoracoplasty / Q000379:methods*; D014183:Transplantation, Heterologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000180:Acrylic Resins; D001672:Biocompatible Materials; C006903:carbopol 940