Larger thoracic defects require stable yet flexible reconstruction to prevent flail chest and debilitating respiratory impairment. We present the use of locking rib-spanning plates as a chest salvage procedure.
A 30-year-old male presented with a massive desmoid tumor in the posterolateral aspect of the chest wall. The mass measured 22 by 14 by 6 cm and involved the posterior third through seventh ribs. The patient underwent wide excision and reconstruction in layers with a porcine dermal substitute for the pleura, locking rib-spanning plates for structural support, and coverage with ipsilateral latissimus dorsi.
The patient tolerated the procedure without complication. He was extubated on postoperative day zero and has had an uneventful course.
Chest wall reconstruction with rib-spanning plates is an alternative method of reconstruction for large chest wall defects. This method limits the foreign body burden while providing rigid structural support. This technique also makes chest wall reconstruction possible in situations that might previously have been treated with pneumonectomy.
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- The use of human acellular dermal matrix for chest wall reconstruction.Ann Thorac Surg. 2010; 90: 1799-1804
- Comparison of acellular dermal matrix and synthetic mesh for lateral chest wall reconstruction in a rabbit model.Plast Reconstr Surg. 2007; 119: 1238-1246
- Prosthetic reconstruction of the chest wall.Thorac Surg Clin. 2010; 20: 551-558
- Reconstruction of complex oncologic chest wall defects: a 10-year experience.Ann Plast Surg. 2004; 52 (discussion 479): 471-479
- Results of chest wall resection and reconstruction with and without rigid prosthesis.Ann Thorac Surg. 2006; 81: 279-285
- Early and long-term results of prosthetic chest wall reconstruction.J Thorac Cardiovasc Surg. 1999; 117 (discussion 591–582): 588-591
- Combined free vascularized iliac osteocutaneous flap and pedicled pectoralis major myocutaneous flap for reconstruction of anterior chest wall full-thickness defect.Ann Thorac Surg. 2011; 91: 586-588
- Chest wall resections and reconstruction: a 25-year experience.Ann Thorac Surg. 2002; 73 (discussion 1725–1726): 1720-1725
- Use of the titanium vertical ribs osteosynthesis system for reconstruction of large posterolateral chest wall defect in lung cancer.Interact Cardiovasc Thorac Surg. 2011; 13: 223-225
- A novel titanium rib bridge system for chest wall reconstruction.Ann Thorac Surg. 2009; 87: e46-48
- XCM biologic tissue matrix. Synthes CMF, West Chester, PA2010
- Matrix RIB. Synthes CMF, West Chester, PA2009
- Titanium plates and dualmesh: a modern combination for reconstructing very large chest wall defects.Ann Thorac Surg. 2011; 91: 1709-1716
- Use of prosthetic materials in chest-wall reconstruction. Assets and liabilities.Surg Clin North Am. 1989; 69: 965-976
- Composite chest wall reconstruction using titanium plates and mesh preserves chest wall function.J Thorac Cardiovasc Surg. 2010; 140: 476-477
Published online: June 18, 2012
Accepted: April 26, 2012
Received: March 4, 2012
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.