Browse > Article

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

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)
Publication Information
Archives of Plastic Surgery / v.38, no.3, 2011 , pp. 228-234 More about this Journal
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
Partial muscle flap; Chest wall reconstruction; Prosthetic material; Combination of flaps;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Losken A, Thourani VH, Carlson GW, Jones GE, Culbertson JH, Miller JI, Mansour KA: A reconstructive algorithm for plastic surgery following extensive chest wall resection. Br J Plast Surg 57: 295, 2004   DOI   ScienceOn
2 Chang RR, Mehrara BJ, Hu QY, Disa JJ, Cordeiro PG: Reconstruction of Complex oncologic chest wall defect: a 10 year experience. Ann Plast Surg 52: 471, 2004   DOI   ScienceOn
3 Kim SC, Park S, Han SH, Lee TJ, Kim DK: Clinical experiences of the chest wall reconstructions. J Korean Soc Plast Reconstr Surg 104: 162, 1999
4 Mansour KA, Thourani VH, Losken A, Reeves JG, Miller JI Jr, Carlson GW, Jones GE: Chest wall resections and reconstruction: a 25-year experience. Ann Thorac Surg 73: 1720, 2002   DOI   ScienceOn
5 Brooks D, Buntic RF: Partial muscle harvest: our first 100 cases attempting to preserve form and function at the dornor site. Microsurgery 28: 606, 2008   DOI   ScienceOn
6 Buntic RF, Horton KM, Brooks D, Lee CK: The free partial superior latissimus muscle flap: preservation of donor-site form and function. Plast Reconstr Surg 121: 1659, 2008   DOI   ScienceOn
7 Buntic RF, Brooks D: Free partial medial rectus muscle flap for closure of complex extremity wounds. Plast Reconstr Surg 116: 1434, 2005   DOI   ScienceOn
8 Skoracki RJ, Chang DW: Reconstruction of the chest wall and thorax. J Surg Oncol 94: 455, 2006   DOI   ScienceOn
9 McCormack PM: Use of prosthetic materials in chest wall reconstruction. assets and liabilities. Surg Clin North Am 69: 965, 1989   DOI
10 Blondeel N, Vanderstraeten GG, Monstrey SJ, Van Landuyt K, Tonnard P, Lysens R, Boeckx WD, Matton G: The donor site morbidity of free DIEP flap and free TRAM flaps for breast reconstruction. Br J Plast Surg 50: 322, 1997   DOI   ScienceOn