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Major chest wall reconstruction after chest wall irradiation
Author(s) -
Larson David L.,
McMurtrey Marion J.,
Howe H. Joe,
Irish C. Edwin
Publication year - 1982
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19820315)49:6<1286::aid-cncr2820490635>3.0.co;2-t
Subject(s) - medicine , sternum , surgery , rib cage , pectoralis major muscle , complication , soft tissue , thoracic wall , latissimus dorsi muscle , anatomy
In the last year, 12 patients have undergone extensive chest wall resection. Eight patients had recurrent cancer after prior resection and irradiation with an average defect of 160 square centimeters, usually including ribs and a portion of the sternum; four had radionacrosis of soft tissue and/or bone. Methods of reconstruction included latissimus dorsi musculocutaneous (MC) flap (five patients), pectoralis major MC flap (seven patients), and omental flap and skin graft (one patient). The donor site was usually closed primarily. All flaps survived providing good wound coverage. The only complication was partial loss of a latissimus dorsi MC flap related to an infected wound; this reconstruction was salvaged with a pectoralis major MC flap. The hospital stay ranged from 10–25 days with a median stay of 11 days. Use of the MC flap is a valuable tool which can be used to significantly decrease morbidity, hospital stay, and patient discomfort related to the difficult problem of chest wall reconstruction after radiation therapy.