CHEST WALL RECONSTRUCTION

Abstract

Reconstruction of chest wall defects has been a constant challenge to the surgeon. Since 1970, numerous authors have made significant contributions to reconstruction of the thorax. Muscle and musculocutaneous flaps of the latissiums dorsi, pectoralis major, serratus anterior, rectus abdominis, and external oblique muscles have been used most frequently (Henly and Sayboid, 1998). The clarification of the functional anatomy and blood supply of these muscles has resulted in more aggressive resections in the treatment of chest wall t\Jmors and in the surgical amelioration of the ravages of radiation therapy (Harrington, 1997). Defects of the chest wall occur almost always as a result of neoplasm, irradiation, or infection and less frequently due to congenital anomalies (McCraw et at., 1998). The chest wall defect produced by resection of most neoplasms involves loss of the skeleton and. frequently the overlying soft tissues as well. Infection, radiation necrosis, and trauma produce partial or full­ thickness defects, depending upon their severity (Azarow et al., 1989). The ability to close large chest wall defects is the main consideration m the surgical treatment of most chest wall afflictions.