A novel technique for the reconstruction of infected full-thickness chest wall defects.

Détails

ID Serval
serval:BIB_B95FA50E2E60
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Titre
A novel technique for the reconstruction of infected full-thickness chest wall defects.
Périodique
Annals of Thoracic Surgery
Auteur(s)
Raffoul W., Dusmet M., Landry M., Ris H.B.
ISSN
0003-4975
Statut éditorial
Publié
Date de publication
2001
Peer-reviewed
Oui
Volume
72
Numéro
5
Pages
1720-1724
Langue
anglais
Notes
Publication types: Case Reports ; Journal Article
Résumé
BACKGROUND: Chest wall resection and reconstruction can be performed with minimal mortality and excellent functional and cosmetic results using synthetic meshes, methylmethacrylate, or other substitutes. However, these techniques are less easily applicable if chest wall resections have to be performed for infections. METHODS: We report a novel technique for this purpose using a modified latissimus dorsi flap harvested in continuity with the thoracolumbar fascia. The vascularized fascia was sutured into the chest wall defect, providing a stable base for the muscular component of the flap. Three patients requiring large full-thickness resections of the anterolateral chest wall for chronic infections were treated accordingly, two presenting with chronic radionecrosis and osteomyelitis and one with chest wall invasion by pulmonary aspergillosis. RESULTS: There were no intraoperative or postoperative complications and immediate extubation was possible in all 3 patients without the need for postoperative ventilation or tracheotomy. Healing of the infected chest wall was observed in all 3 patients. Postoperative cinemagnetic resonance imaging revealed concordant movements of the replaced segments without evidence of paradoxical motion during inspiration and expiration. CONCLUSIONS: This technique is easy and safe. It allows a stable and satisfactory reconstruction after large anterolateral full-thickness chest wall resections of infected, previously irradiated tissues, using only well-vascularized autologous tissue.
Mots-clé
Aged, Female, Humans, Middle Aged, Reconstructive Surgical Procedures/methods, Soft Tissue Infections/surgery, Surgical Flaps, Thorax
Pubmed
Web of science
Création de la notice
29/01/2008 14:00
Dernière modification de la notice
03/03/2018 20:51
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