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Year : 2018  |  Volume : 35  |  Issue : 2  |  Page : 122-127

Chest wall reconstruction for traumatic chest wall lesions

Department of Cardiothoracic Surgery, Faculty of Medicine, Benha University, Benha, Egypt

Correspondence Address:
Dr. Ataa E.A. Abdallah
7 Masged Eltoba Street, Qusena, Elmenoufia, 32511
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1110-208X.239201

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Background The study was conducted to project the different available surgical modalities of chest wall reconstruction for different traumatic chest wall lesions. Patients and methods Sixty patients were divided into two equal groups of 30 patients each. In the first group, skeletal tissue reconstruction was performed using plates and screws in 15 patients. In the second group, soft tissue reconstruction was performed using latissimus dorsi flap in 15 patients and using pectoralis major flap in the other 15 patients. The mandibular plate was the type used in fixation with three interlocking screws on each side of fracture. The prolene mesh was sutured to margins of skeletal defects with interrupted prolene sutures and then covered with muscle flap. The latissimus dorsi flap was used to cover lateral and anterior soft tissue defects. In addition, pectoralis major flap was used to cover superioanterior and upper lateral soft tissue defects. Each patient was assessed for primary outcomes such as ICU admission, mechanical ventilation, and hospital stay and secondary outcomes such as deformity, redo surgery, and death. Results The need for mechanical ventilation, ICU admission, seroma formation, redo surgery, hospital stay, and deformity are more decreased in the plates and screws subgroup than in prolene mesh reconstruction, but no difference was found in chest infection, wound infection, and death between the two subgroups. However, flap hematoma, seroma formation, and residual deformity are more decreased in pectoralis major flap than in latissimus dorsi flap. Conclusion Fixation of fractures with metal plates and screws decrease morbidity. Most skeletal chest wall defects can be reconstructed with prolene mesh. The latissimus dorsi and pectoralis major flaps are the most versatile and reliable flaps used in reconstruction today.

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