J Korean Soc Plast Reconstr Surg.  2004 Nov;31(6):784-789.

Selection Flaps in Chest Wall Reconstruction after Open Drainage for Empyema

• Moon JS
• Hwang SM
• Kim KT
• Nam SB
• Bae YC
• Kim YD

Abstract

The purpose of reconstruction of chest wall defect after open drainage in chronic empyema is the control and prevention of recurrent infection, obliteration of dead space in thoracic cavity, and coverage of open wound. For the obliteration of empyema cavities, latissimus dorsi, pectoralis major or rectus abdominis flaps are commonly used. Among them, latissimus dorsi flap based on thoracodorsal pedicle is most versatile and most reliable. If the latissimus dorsi flap can not be used, the author uses pectoralis major flap or rectus abdominis flap depending on the location and the size of dead space and skin defect. The author reports the results of eight patients who underwent reconstruction of chest wall defect with bronchopleural fistula in empyema using muscle flaps. The author performed 4 latissimus dorsi flaps, 3 pectoralis major flaps, 1 rectus abdominis flap according to various situations. According to the size of dead space and skin defect, the author also performed deepithelized musculocutaneous flap, musculocutaneous flap or muscle flap respectively. During the follow-up period, recurrence of empyema, flap survival, morbidity of donor site and patient's satisfaction were evaluated. There was no recurrence of empyema or wound complication. Also, patients were satisfied with the results of operation. The results demonstrate reliability of various muscle flaps and author's method in selection of reconstruction flap for the chest wall defect after open drainage in empyema.

Keyword

Chest wall reconstruction; Chronic empyema; Latissimus dorsi flap; Pectoralis major flap; Rectus abdominis flap

MeSH Terms

Drainage*
Empyema*
Fistula
Follow-Up Studies
Humans
Myocutaneous Flap
Rectus Abdominis
Recurrence
Skin
Superficial Back Muscles
Thoracic Cavity
Thoracic Wall*
Thorax*
Tissue Donors
Wounds and Injuries