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Management of Post-lobectomy Bronchopleural-cutaneous Fistula With a Rectus Abdominis Free Flap  

Heo, Chan Yeong (Department of Plastic and Reconstructive Surgery, The college of medicine, Seoul National University Hospital)
Min, Kyung Hee (Department of Plastic and Reconstructive Surgery, The college of medicine, Seoul National University Hospital)
Eun, Seok Chan (Department of Plastic and Reconstructive Surgery, The college of medicine, Seoul National University Hospital)
Baek, Rong Min (Department of Plastic and Reconstructive Surgery, The college of medicine, Seoul National University Hospital)
Cheon, Sang Hoon (Department of Thoracic and Cardiovascular Surgery, The college of medicine, Seoul National University Hospital)
Publication Information
Archives of Plastic Surgery / v.36, no.6, 2009 , pp. 795-798 More about this Journal
Abstract
Purpose: The repair of complex chest wall defects presents a challenging problem for the reconstructive surgeon. In particular, a free flap is often required when the defect is large, in which case suitable recipient vessels must be found to insure revascularization. The authors report a case of persistent bronchopleural - cutaneous fistula developed after undergoing lobectomy for lung cancer. Methods: The defect area was repaired using a free vertical rectus abdominis muscle flap revascularized by microvascular anastomosis to the 6th intercostal pedicle. The flap obliterated the right chest cavity, closed the site of empyema drainage, and aided healing of a bronchopleural - cutaneous fistula. Results: The patient has remained healed for 14 months without any postoperative complications and recurrent infection or fistula. Conclusion: We suggest that a rectus abdominis musculocutaneus free flap and intercostal pedicle as a recipient could be a useful method for repair of chest defects.
Keywords
Bronchopleural-cutaneous fistula; Rectus abdominis free flap; Intercostal vessel;
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