RT Book, Section
A1 Orgill, Dennis P.
A1 Butler, Charles E.
A1 Fine, Neil A.
A2 Sugarbaker, David J.
A2 Bueno, Raphael
A2 Burt, Bryan M.
A2 Groth, Shawn S.
A2 Loor, Gabriel
A2 Wolf, Andrea S.
A2 Williams, Marcia
A2 Adams, Ann
SR Print(0)
ID 1170415127
T1 Options for Soft Tissue Chest Wall Reconstruction
T2 Sugarbaker’s Adult Chest Surgery, 3e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781260026931
LK accesssurgery.mhmedical.com/content.aspx?aid=1170415127
RD 2024/09/14
AB The  bony  thorax,  with  its  overlying  muscles  and  integument,  creates  a  cage  that  protects  the  relatively  fragile  heart,  great  vessels,  lungs,  esophagus,  and  large  lymphatics.  Disruption  of  the  thorax  by  trauma,  tumor,  congenital  anomaly,  infection,  or  surgical  intervention  can  have  potentially  lethal  consequences.  Advances  in  cardiac  and  thoracic  surgery  have  enabled  surgeons  to  operate  safely  within  these  cavities.  Positive  pressure  ventilation  with  the  use  of  selective  tubes  and  bronchial  blockers  permits  surgeons  to  open  the  pleural  spaces  and  continue  respiration  while  the  pleural  cavity  is  disrupted.  Advances  in  cardiac  surgery  include  cardiopulmonary  bypass,  extracorporeal  membrane  oxygenation,  intra-aortic  balloon  pumps,  and  ventricular  assist  devices  that  permit  continued  or  augmented  perfusion  with  oxygenated  blood.  These  advances  combined  with  a  better  understanding  of  biomaterials,1–3  tissue-engineered  solutions,  and  advances  in  plastic  and  reconstructive  surgery4–6  have  allowed  more  complex  sternal  and  chest  wall  defects  to  be  successfully  reconstructed.  In  this  chapter,  we  will  focus  our  efforts  on  the  multidisciplinary  approach  to  reconstruction  of  the  chest  and  highlight  the  three  most  common  flaps  used  for  large  defects:  the  latissimus  dorsi,  pectoralis  major,  and  omental  flaps.