Chest Wall Reconstruction Using Iliac Bone Allografts and Muscle Flaps

Abstract

Technically we can divide full-thickness thoracic reconstruction into 2 parts: providing a rigid support and ensuring well-vascularized coverage. Since 1986, the authors' center has had ample experience with bone banks and the use of cryopreserved bone grafts, which led them to consider the possibility of using these grafts for full-thickness chest wall reconstruction. They describe 3 patients in whom resection of the tumor and reconstruction of the thorax were carried out using iliac bone allografts covered with muscle flaps (1 pectoralis major and 2 rectus abdominis). None of the patients experienced breathing difficulties, pain, or instability after 14 months, 18 months, and 11 years of follow-up. The result of the reconstruction was excellent in all 3 patients in terms of function and aesthetics. The advantage of allografts compared with synthetic materials is their potential integration; they can become part of the host patient's living tissue.

Sternal resection and reconstruction after malignant tumours

“…A PMF is more often performed in men: 4 cases in this series from the 5 patients who underwent this type of reconstruction (Table 1). In women a LDF is commonly used [13,14], especially in breast cancer cases where the pectoral region has often previously been extirpated. Omentoplasty may be a difficult procedure in some patients, mainly in cases of extensive resections, irradiated fields or recurrent tumours [15].…”

A new alternative for bony chest wall reconstruction using biomaterial artificial rib and pleura: animal experiment and clinical application☆☆☆

“…Traditionally, reconstruction of the skeletal framework with either naturally derived or prosthetic materials such as autogenous rib grafts, fascia lata, bone allografts, Marlex mesh, polytetrafluoroethylene (PTFE) patches, metal sheets, and methylmethacrylate has been demonstrated in the literature [9][10][11][12][13][14]. Each of these materials can be categorized into one of three kinds: autologous tissue, allograft transplants (allogenic or xenogenic), and synthetic materials.…”

“…[ ( ) T D $ F I G ] Compared with synthetic materials, allogenic and xenogenic materials are advantageous because the latter materials can potentially integrate with the host's tissues [11]. Nonetheless, rejection and risk of pathophoresis (transmission of disease) remain important concerns that currently limit the clinical use of these tissues [11].…”

“…Nonetheless, rejection and risk of pathophoresis (transmission of disease) remain important concerns that currently limit the clinical use of these tissues [11].…”

Perforator Flaps Covering Alloplastic Materials in Full-Thickness Chest Wall Defects Reconstruction: A Safe Option?

“…6 This asseveration is extended even when bony reconstruction is carried out employing osseous allograft instead of manufactured synthetic materials. 7 The main advantage of muscle flaps in these situations is the powerful blood supply they provide, preventing infection in the presence of inert materials. Moreover, they offer a heavy interface between skin and the synthetic mesh.…”