Usefulness of Partial Muscle Flaps and Combination Method for Coverage of Prosthetic Material in Chest Wall Reconstruction

흉벽 재건에서 합성 물질의 피복을 위한 부분 근피판 조합의 효용성

  • Ryoo, Suk-Tae (Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine) ;
  • Pyon, Jai-Kyong (Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine) ;
  • Lim, So-Young (Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine) ;
  • Mun, Goo-Hyun (Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine) ;
  • Bang, Sa-Ik (Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine) ;
  • Oh, Kap-Sung (Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine)
  • 류석태 (성균관대학교 의과대학 삼성병원 성형외과학교실) ;
  • 변재경 (성균관대학교 의과대학 삼성병원 성형외과학교실) ;
  • 임소영 (성균관대학교 의과대학 삼성병원 성형외과학교실) ;
  • 문구현 (성균관대학교 의과대학 삼성병원 성형외과학교실) ;
  • 방사익 (성균관대학교 의과대학 삼성병원 성형외과학교실) ;
  • 오갑성 (성균관대학교 의과대학 삼성병원 성형외과학교실)
  • Received : 2011.02.25
  • Accepted : 2011.04.15
  • Published : 2011.05.10

Abstract

Purpose: Reconstruction of chest wall has always been a challenging problem. Muscle flaps for chest wall reconstruction have been helpful in controling infection, filling dead space and covering the prosthetic material in this challenge. However, when we use muscle flaps, functional and cosmetic donor site morbidities could occur. The authors applied and revised various partial muscle flaps and combination use of them to cover the prosthetic material for the chest wall reconstruction and evaluated the usefulness of partial muscle flaps. Methods: This study included 7 patients who underwent chest wall reconstruction using partial muscle flap to cover prosthetic material from 2004 to 2008. The pectoralis major muscle was used in anterior 2/3 parts of it leaving lateral 1/3 parts of it. The anterior 2/3 parts of the pectoralis major muscle were used while lateral 1/3 parts were left. In case of the rectus abdominis muscle flap, we used upper half of it, or we dissected it around its origin and then advanced to cover the site. The latissimus dorsi muscle flap was elevated with lateral portion of it along the descending branch of the thoracodorsal artery. If single partial muscle flap could not cover whole prosthetic material, it would be covered with combination of various partial muscle flaps adjacent to the coverage site. Results: Flap coverage of the prosthetic material and chest wall reconstructions were successfully done. There occurred no immediate and delayed post operative complications such as surgical site infection, seroma, deformity of donor site and functional impairment. Conclusion: When we use the muscle flaps to cover prosthetic material for chest wall reconstruction, use of the partial muscle flaps could be a good way to reduce donor site morbidity. Combination of multiple partial flaps could be a valuable and good alternative way to overcome the disadvantages of partial muscle flaps such as limitation of volume and size as well as flap mobility.

Keywords

References

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