Objective: To determine the outcomes of the use of the Latissimus Dorsi Flap for the Reconstruction of Complex Chest Wall Defects: Is a polypropylene mesh and a flap enough?
Study Design: Descriptive case series.
Place and Duration of Study: The study was conducted in the department of Plastic and Reconstructive Surgery Shifa International Hospital Islamabad, over a period of 5 years between Jan 2012 and Dec 2016.
Material and Methods: All patients with chest wall defects, post tumor resection diagnosed on tissue biopsy, trauma, osteoradionecrosis and infection were included in this study. The chest wall was reconstructed with a polypropylene mesh and the latissimus dorsi flap. All the patients with tumors were discussed in multidisciplinary team meeting. Patients with post coronary artery bypass surgery wounds were excluded from this study. Demographic data including age, sex, histopathological diagnosis of disease and other outcomes were studied.
Results: Total 22 patients were included in this study over a period of 05 years, 16 patients with tumors. Age range was 12 to 63 years. Mean follow up time was 3 years. Six patients developed postoperative complications: one patient had partial skin graft loss at the recipient site. Two patients developed partial wound dehiscence one at the donor area and other at the flap inset site. One patient had partial distal flap loss and graft loss at donor area. There was no mortality in our series.
Conclusion: Our study revealed that the polypropylene mesh covered with the latissimus dorsi myocutaneous flap is adequate for skeletal stabilization of composite chest wall defects achieving satisfactory functional and aesthetic results.
Keywords : Chest Wall Reconstruction, Chest Wall Tumors, Latissimus dorsi flap, Pedicled flap, Polypropylene mesh