Acellular dermal matrix and bone cement sandwich technique for chest wall reconstruction

Heo, Chan Yeong; Kang, Byungkwon; Jeong, Jae Hoon; Kim, Kwhanmien; Myung, Yujin

doi:10.5999/aps.2021.01067

Cited by 5 publications

(14 citation statements)

References 10 publications

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“…One of the most common composites is the combination of polymethylmethacrylate in two layers of the propylene mesh, placed as a “sandwich” ( 21 ), but several materials could be mixed, such as rigid+non-rigid synthetic prostheses, autologous + synthetic prostheses, xenograft + synthetic prostheses, and so on. The report by Heo et al ( 25 ) is an example of how rigid and non-rigid synthetic prosthetic meshes along with xenografts could be combined at the same time: in six patients, after the removal of the chest wall tumor, the visceral pleura was repaired with Gore-Tex; the first layer of the acellular dermal matrix was placed on Gore-Tex, then bone cement was used as a substitute for ribs, and finally the second layer of the acellular dermal matrix was sutured with the first one, preventing the contact of the cement with the soft tissue. No major complications occurred, and no perioperative mortality was reported.…”

Section: Discussionmentioning

confidence: 95%

Chest wall reconstruction in benign and malignant tumors with non-rigid materials: An overview

Colella¹,

Brandimarte²,

Marra

et al. 2022

Front. Surg.

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Several materials and techniques have been described for the procedure of chest wall reconstruction: the choice of using a technique or a material over another relies mainly on the surgeon's experience as well as thoracic defect localization and dimension, local availability of materials, and costs. From a technical point of view, autologous and alloplastic reconstruction are available, and, in both cases, rigid and non-rigid prostheses are found. Each material has its peculiarities, with advantages and disadvantages; thus, it is mandatory to be confident when planning the intervention to foresee possible complications and minimize them. We have reviewed the literature on chest wall reconstruction in chest wall tumors (both malignant and non malignant) with non-rigid prosthetic materials, focusing on safety outcomes.

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Section: Discussionmentioning

confidence: 95%

Chest wall reconstruction in benign and malignant tumors with non-rigid materials: An overview

Colella¹,

Brandimarte²,

Marra

et al. 2022

Front. Surg.

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“…They discovered positive outcomes, and none of the patients experienced postoperative complications or soft tissue defects (29). They demonstrated the safety of ADM and its substitutability in chest wall repair after tumor removal (Supplementary Table S1) (29). Also, Giordano et al (93), in a study, compared the postoperative complications of mesh vs. ADM in chest wall reconstruction.…”

Section: Chestmentioning

confidence: 99%

“…Chest wall defects are frequently caused by tumor herniation and resection (1,2,21,29,30,(81)(82)(83)(84)(85)(86)(87)(88)(89)(90)(91). Defects in the chest wall impair the strong framework that supports breathing and safeguards the viscera (92).…”

Section: Chestmentioning

confidence: 99%

“…Consequently, it is essential to repair the chest wall properly (50). The material typically employed in chest wall repair is synthetic mesh (1,2,21,29,30,(81)(82)(83)(84)(85)(86)(87)(88)(89)(90)(91). It does, however, have drawbacks (for example, infection) (93).…”

Section: Chestmentioning

confidence: 99%

“…It does, however, have drawbacks (for example, infection) (93). ADM has so been the subject of investigations to replace the mesh in these operations (Figure 1D) (1,2,21,29,30,33,36,68,(81)(82)(83)(84)(85)(86)(87)(88)(89)(90)(91)(94)(95)(96)(97)(98)(99)(100)(101).…”

Section: Chestmentioning

confidence: 99%

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Acellular dermal matrix in reconstructive surgery: Applications, benefits, and cost

Mohammadyari

Parvin²,

Khorvash³

et al. 2023

Front. Transplant.

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Modern tissue engineering has made substantial advancements that have revolutionized plastic surgery. Acellular dermal matrix (ADM) is an example that has gained considerable attention recently. ADM can be made from humans, bovines, or porcine tissues. ADM acts as a scaffold that incorporates into the recipient tissue. It is gradually infiltrated by fibroblasts and vascularized. Fortunately, many techniques have been used to remove cellular and antigenic components from ADM to minimize immune system rejection. ADM is made of collagen, fibronectin, elastin, laminin, glycosaminoglycans, and hyaluronic acid. It is used in critical wounds (e.g., diabetic wounds) to protect soft tissue and accelerate wound healing. It is also used in implant-based breast reconstruction surgery to improve aesthetic outcomes and reduce capsule contracture risk. ADM has also gained attention in abdominal and chest wall defects. Some studies have shown that ADM is associated with less erosion and infection in abdominal hernias than synthetic meshes. However, its higher cost prevents it from being commonly used in hernia repair. Also, using ADM in tendon repair (e.g., Achilles tendon) has been associated with increased stability and reduced rejection rate. Despite its advantages, ADM might result in complications such as hematoma, seroma, necrosis, and infection. Moreover, ADM is expensive, making it an unsuitable option for many patients. Finally, the literature on ADM is insufficient, and more research on the results of ADM usage in surgeries is needed. This article aims to review the literature regarding the application, Benefits, and costs of ADM in reconstructive surgery.

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Application of Titanium Mesh in the Early Treatment of Flail Chest

Liu,

Zhou,

et al. 2024

International Journal of Biomaterials

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Objective: To investigate the effect of the titanium mesh on flail chest and bone healing from clinical and animal experiments.Methods: Clinical experiment: 24 patients with flail chests in our hospital from January 2020 to January 2023 were prospectively selected and divided into control and titanium mesh groups according to different treatment plans and basic data‐matching principles, with 12 cases in each group. The control group was treated with conservative external fixation, and the titanium mesh group was treated with titanium mesh fixation. The clinical efficacy index, visual analog scale and blood gas indexes and hemodynamic indexes of the two groups of patients were recorded. Chest CT and pulmonary function and life quality were examined after operation. Animal experiment: The flail chest sheep were treated conservatively with a titanium mesh, and the expression of bone‐healing‐related proteins was detected.Results: The mechanical ventilation time, drain indwelling time, ICU observation time, and hospital time in the titanium mesh group were significantly shorter than those in the control group (p < 0.05). The PaO2, CVP, FVC, FEV1, MVV, and life quality of the titanium mesh group were significantly better than those of the control group after operation, and the visual analog scale, PaCO2, CI, ELWI, and the proportions of atelectasis, thoracocyllosis, and consolidation tardive after operation were significantly lower than those of the control group (p < 0.05). The expressions of BMP2, IGF‐1, VEGF, and PDGFD in the rib tissue of titanium mesh sheep were higher than those of control sheep at 4 weeks after operation (p < 0.05).Conclusion: Titanium mesh is a safe and effective treatment for flail chest, which can improve pain, blood gas, hemodynamic indexes, and pulmonary function and promote fracture healing.

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Acellular dermal matrix and bone cement sandwich technique for chest wall reconstruction

Cited by 5 publications

References 10 publications

Chest wall reconstruction in benign and malignant tumors with non-rigid materials: An overview

Chest wall reconstruction in benign and malignant tumors with non-rigid materials: An overview

Acellular dermal matrix in reconstructive surgery: Applications, benefits, and cost

Application of Titanium Mesh in the Early Treatment of Flail Chest

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