Arch Reconstr Microsurg.  2015 May;24(1):28-31. 10.15596/ARMS.2015.24.1.28.

Preserved Respiratory Function after Reconstruction of a Large Chest Wall Defect

• Kim YJ
• Kim YJ
• Lee JI

• KMID: 1794097
• DOI: http://doi.org/10.15596/ARMS.2015.24.1.28

Abstract

A case report of a patient who developed radiation-induced sarcoma in the left chest wall is presented. The patient had partial mastectomy and adjuvant radiation therapy (total dose, 5,220 cGy) and chemotherapy. Five years later, she visited with rapidly growing mass with central ulceration in the irradiated chest wall. The mass was diagnosed as malignant fibrous histiocytoma. The chest wall mass resected en bloc (23x18 cm) including five consecutive ribs. After the defected thoracic cage was reinforced using a polytetrafluoroethylene patch, omental flap and split thickness skin graft was done for soft tissue coverage. We applied negative pressure wound closer system for effective suction of omeantal exudate. The wound healed without complications. The patient suffered no perioperative pulmonary complications. Pulmonary function tests showed no significant changes. Each of Gore-Tex, omental flap, negative pressure wound therapy and skin graft is widely used method. However, If these methods are used in combination, we can reconstruct the large defect of chest wall including multiple ribs without any repiratory function problems.

Keyword

Sarcoma; Radiation-induced; Respiratory function tests; Thoracic wall; Omentum

MeSH Terms

Drug Therapy
Exudates and Transudates
Histiocytoma, Malignant Fibrous
Humans
Mastectomy, Segmental
Negative-Pressure Wound Therapy
Omentum
Polytetrafluoroethylene
Respiratory Function Tests
Ribs
Sarcoma
Skin
Suction
Thoracic Wall*
Transplants
Ulcer
Wounds and Injuries
Polytetrafluoroethylene