Reconstruction of Chest Wall Using a Two-Layer Prolene Mesh and Bone Cement Sandwich

Abstract

Wide surgical resection is the most effective treatment for the vast majority of chest wall tumors. This study evaluated the clinical success of chest wall reconstruction using a Prolene mesh and bone cement prosthetic sandwich. The records of all patients undergoing chest wall resection and reconstruction were reviewed. Surgical indications, the location and size of the chest wall defect, diaphragm resection, pulmonary performance, postoperative complications, and survival of each patient were recorded. From 1998 to 2008, 43 patients (27 male, 16 female; mean age of 48 years) underwent surgery in our department to treat malignant chest wall tumors: chondrosarcoma (23), osteosarcoma (8), spindle cell sarcoma (6), Ewing's sarcoma (2), and others (4). Nine sternectomies and 34 antero-lateral and postero-lateral chest wall resections were performed. Postoperatively, nine patients experienced respiratory complications, and one patient died because of respiratory failure. The overall 4-year survival rate was 60 %. Chest wall reconstruction using a Prolene mesh and bone cement prosthetic sandwich is a safe and effective surgical procedure for major chest wall defects.

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

“…To date, methods to reconstruct the chest wall, including the pleura and muscular layers, have involved using synthetic materials and covering them with autologous flaps if needed 3 4 5 . Rigid prostheses have also been used for the reconstruction of defects of the rib cage.…”

“…Various prosthetic materials have been used for reconstruction. There are methods to reconstruct pleura and soft tissue using synthetic materials such as polypropylene and polyester [ 3 ] and to perform rigid fixation in skeletal reconstruction by sandwiching bone cement between these materials [ 4 , 5 ]. However, these methods have major disadvantages.…”

Management Challenge in Chest Wall Neoplasms

“…Optimal outcomes for malignant tumors can be achieved with complete resection and appropriate chest wall reconstruction with muscle flaps or prosthesis. 12,13 In our study, immediate closure of defect was performed in all patients.…”

Synthesis, structure, and properties of carbon/carbon composites artificial rib for chest wall reconstruction

“…In the 1980s, bone cement polymethylmethacrylate (PMMA) was applied in chest wall reconstruction. Later, stainless-steel plate and titanium alloy were adopted for chest wall reconstruction 3 .…”

“…For example, the hand-made PMMA implants could easily induce postoperative soft tissue hematoma and infection due to their low surface flatness and rough edges. Moreover, they are prone to fragmentation and fracture when subjected to the external force 3 . The metal products, like stainless steel and titanium alloys, are generally incompatible to human tissues 4 – 6 .…”