The Annals of Thoracic Surgery, Vol 32, 329-336, Copyright © 1981 by The Society of Thoracic Surgeons
Repair of large chest wall defects: experience with 23 patients
H Eschapasse, J Gaillard, F Henry, G Fournial, F Berthoumieu and X Desrez
The repair of large chest wall defects has been done on 23 patients who had
28 operations. Twenty-two patients had a neoplasm of the thoracic cage,
while 1 had a large inflammatory mass. Nine patients had a partial lung and
3 a partial diaphragmatic resection done en bloc with the ribs. Seven
resections were on the sternum. The repair was made either with a soft
prosthesis (nylon mesh in 3 and Marlex mesh in 12 operations) or with a
composite prosthesis of methyl methacrylate and metallic or Marlex mesh (13
operations). The association of methyl methacrylate and Marlex combines the
solidity and the easy shaping of methyl methacrylate with the advantages of
the mesh for an easy fixation and excellent incorporation. When the skin
and the muscles are resected with the osteocartilaginous wall, an omentum
flap is placed between the skin and the prosthesis to facilitate healing.
There was one postoperative wound infection, which cleared with appropriate
antibiotics. No prosthesis has extruded. The cosmetic and functional
results are satisfactory. Repair of very large chest wall defects after
resection can be done safely.
