Immediate Skeletal Reconstruction of an Extensive Bilateral Defect of the Anterior Chest Wall

Longacre, J. J.; Maurer, Elmer P.; Keirle, Alfred M.

doi:10.1097/00006534-197405000-00027

Cited by 9 publications

(3 citation statements)

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“…Various materials were tried to give additional stability to the chest wall [5]. Autogenous tissue included bone (split ribs, iliac struts) [1,19,[33][34][35] and cartilage grafts, osteoperiosteal flaps [36] and fascia lata strips [37,38]. Prosthetic materials [39] included tantalum, stainless steel, fiberglass, Ivalon | Lucite | and Proplast | [40].…”

Section: Historical Notesmentioning

confidence: 99%

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An approach to repair of radiation necrosis of chest wall and mammary gland

Sando

Jurkiewicz

1986

World j. surg.

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Chest wall reconstruction following radiation no longer need be a protracted sequence of multiple stage tissue transfer with potential necrosis of the flap at each step. Muscle flaps with or without the overlying skin provide very reliable and effective methods of single-stage repair. For the anterior chest the latissimus dorsi, the rectus abdominis, and pectoralis muscles are the choices with omentum as an alternative in salvage cases. For the posterior chest, choices are the latissimus dorsi or trapezius.In selected patients, breast reconstruction can be offered. The use of either the rectus abdominis or latissimus dorsi musculocutaneous flap, singly or in tandem, is the current preferred choice.In the treatment of primary, recurrent, and unresectable chest wall malignancies [1] (e.g., breast [2-17], lung [5], chest wall tumors [8,18], deeply infiltrating skin tumors [10,19]), metastatic disease (e.g., pulmonary seminoma [6]), spinal cord and column metastases (e.g., breast, lung), or primary mediastinal tumors (e.g., lymphoma) [1,20,21], chest wall irradiation is useful and essential. Risks of therapy include not only damage to underlying lung parenchyma, mediastinal viscera, and chest wall and its overlying skin, but also the induction of neoplasia in these sites [3,13,22,23].These hazards of radiation therapy have been observed in virtually every tissue system. Particularly sensitive are those structures with high cellular turnover rates, e.g., breast, bone marrow, and thyroid [3,23]. The first 2 of these are primary constituents of the chest wall. Restoration of the radiation-injured chest wall often requires signifi-Reprint requests:

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Section: Historical Notesmentioning

confidence: 99%

“…Early orthovoltage wounds often could be excised in toto, leaving behind a bed suitable for skin grafting. With megavoltage, however, skin graft survival has been universally poor [9,16,29,35]. Local random flaps have also fared poorly [43] even with delay [31].…”

Section: Historical Notesmentioning

confidence: 99%

An approach to repair of radiation necrosis of chest wall and mammary gland

Sando

Jurkiewicz

1986

World j. surg.

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“…Stabilization of the chest wall has been achieved with the use of foreign implants, such as tantalum plate" (later condemned1"), fiberglass,11 stainless steel, and Marlex mesh1-and polyester film. 13 Carberry and Ballantyne" described the use of an omental flap to close a large anterior wall defect. The following case report is illustra¬ tive.…”

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confidence: 99%

Reconstruction of a Large Chest Wall Defect Using Greater Omentum

Jacobs¹

1978

Arch Surg

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The development of a light curing prosthesis for chest wall replacement

Ambrogi

Tsang²,

Jones³

et al. 1992

European Journal of Cardio-Thoracic Surgery

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In conjunction with colleagues in the chemical industry, we have developed and evaluated a new plastic prosthesis which we hope will supplant presently used materials for chest wall replacement. We have modified the basic chemical of a reactive resin routinely used in orthopaedic and dental work by the inclusion of a polypropylene mesh. The resultant material is thin enough to cut with scissors and yet supple enough to shape to fit the defects. It is hardened by exposure to UV light and has a practical cure time when exposed to normal light in the operating theatre. When set it is strong and rigid. The mechanical properties have been studied with the Flexural 3-point bend test and compared with the best of the presently available prostheses. The inert nature of the material was studied in a subcutaneous implant in 29 rats over 3 months. Histology has shown a lack of reactivity. The stability in vivo was studied using the material to replace portions of the chest wall in rabbits for up to 6 months. Subsequent histology and in-vitro testing have proved satisfactory. The ability of this material to withstand the dynamic stresses of the chest wall have been studied by its implantation into the chest wall of 3 minipigs for 6 months. The material looks promising and has proved more "user friendly" than existing prostheses for flat bone replacement. We hope to refine its production to allow its use in humans.

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Immediate Skeletal Reconstruction of an Extensive Bilateral Defect of the Anterior Chest Wall

Cited by 9 publications

References 0 publications

An approach to repair of radiation necrosis of chest wall and mammary gland

An approach to repair of radiation necrosis of chest wall and mammary gland

Reconstruction of a Large Chest Wall Defect Using Greater Omentum

The development of a light curing prosthesis for chest wall replacement

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