Reconstruction of full-thickness defects of the thoracic wall by myocutaneous flap transfer: Latissimus dorsi compared with transverse rectus abdominis

Angelo Galli, Edoardo Raposio, Pierluigi Santi

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Ten patients with primary or recurrent cancer of the chest wall underwent full-thickness resection and immediate reconstruction of the defect by placement of an alloplastic implant and transposition of a latissimus dorsi (n = 5) or transverse rectus abdominis (n = 5) myocutaneous flap. When up to three ribs were removed, these were replaced by a reabsorbable mesh sutured to the residual rib stumps. Larger skeletal defects were stabilized by placement of a permanent mesh or polytetrafluoroethylene (PTFE) sheet. In only one case the PTFE reconstruction was reinforced by metallic implants, but that caused dehiscence of the overlying flap suture, leading to major complications and eventually death. Both the latissimus dorsi and the rectus abdominis myocutaneous flaps were ideally suited to soft tissue reconstruction. There were no appreciable complications concerning viability of the flaps, and the operating time needed for the transposition of the two flaps was similar. The rectus abdominis flap showed a distinct advantage when an absorbable mesh was to be covered, as its superior thickness minimized the risk of creating a 'flail' reconstructed chest wall. This advantage was in part counter-balanced by the more limited arc of rotation compared with the latissimus dorsi flap.

Original languageEnglish
Pages (from-to)39-43
Number of pages5
JournalScandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery
Volume29
Issue number1
DOIs
Publication statusPublished - 1995

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Rectus Abdominis
Myocutaneous Flap
Superficial Back Muscles
Thoracic Wall
Polytetrafluoroethylene
Ribs
Flail Chest
Sutures
Neoplasms

Keywords

  • Full-thickness defects
  • Myocutaneous flaps
  • Thoracic wall

ASJC Scopus subject areas

  • Surgery

Cite this

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abstract = "Ten patients with primary or recurrent cancer of the chest wall underwent full-thickness resection and immediate reconstruction of the defect by placement of an alloplastic implant and transposition of a latissimus dorsi (n = 5) or transverse rectus abdominis (n = 5) myocutaneous flap. When up to three ribs were removed, these were replaced by a reabsorbable mesh sutured to the residual rib stumps. Larger skeletal defects were stabilized by placement of a permanent mesh or polytetrafluoroethylene (PTFE) sheet. In only one case the PTFE reconstruction was reinforced by metallic implants, but that caused dehiscence of the overlying flap suture, leading to major complications and eventually death. Both the latissimus dorsi and the rectus abdominis myocutaneous flaps were ideally suited to soft tissue reconstruction. There were no appreciable complications concerning viability of the flaps, and the operating time needed for the transposition of the two flaps was similar. The rectus abdominis flap showed a distinct advantage when an absorbable mesh was to be covered, as its superior thickness minimized the risk of creating a 'flail' reconstructed chest wall. This advantage was in part counter-balanced by the more limited arc of rotation compared with the latissimus dorsi flap.",
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