Reconstruction of chronic radiation-induced ulcers in the chest wall using free and pedicle flaps
Background and purposeResection of radiation-induced ulcers often causes full-thickness defects of the chest wall. We retrospectively reviewed and evaluated 17 patients to explore a method of chest wall reconstruction.Materials and methodsA total of 17 breast cancer patients with radiation-induced u...
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Frontiers Media S.A.
2022-11-01
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Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1010990/full |
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author | Bo Zhou Ying Long Sha Li Chunliu Lv Dajiang Song Yuanyuan Tang Liang Yi Zhenhua Luo Gaoming Xiao Zan Li Xiao Zhou |
author_facet | Bo Zhou Ying Long Sha Li Chunliu Lv Dajiang Song Yuanyuan Tang Liang Yi Zhenhua Luo Gaoming Xiao Zan Li Xiao Zhou |
author_sort | Bo Zhou |
collection | DOAJ |
description | Background and purposeResection of radiation-induced ulcers often causes full-thickness defects of the chest wall. We retrospectively reviewed and evaluated 17 patients to explore a method of chest wall reconstruction.Materials and methodsA total of 17 breast cancer patients with radiation-induced ulcers were included. Various type of prostheses and flaps were used, results of clinic were evaluated.ResultsSixteen patients had full-thickness defects and one patient had only a soft tissue defect and underwent reconstruction with a pedicle latissimus dorsi (LD) myocutaneous flap. Among all 16 full-thickness defect cases, 15 patients underwent bony thoracic reconstruction using polymesh/3D-printed titanium plates or methyl methacrylate. For soft tissue reconstruction, 13 patients reconstruction using a free deep inferior epigastric perforator (DIEP) flap in combination with a contralateral transverse rectus abdominis myocutaneous (TRAM) flap, and 2 underwent pure free DIEP flap reconstruction. Among all the patients 15 healed with no complications, and 2 patients had delayed healing on the edges of the flaps.ConclusionsDistant pedicle or free flap can used for soft tissue defect coverage, for those severe patients with full-thickness defects and used prostheses, free deep inferior epigastric perforator flap in combination with a contralateral transverse rectus abdominis myocutaneous flap (TRAM + DIEP) would be an applicable choice. |
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language | English |
last_indexed | 2024-04-12T08:12:17Z |
publishDate | 2022-11-01 |
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series | Frontiers in Surgery |
spelling | doaj.art-5d87b4a9cb5d4e16b0aeabc3a54777452022-12-22T03:40:55ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-11-01910.3389/fsurg.2022.10109901010990Reconstruction of chronic radiation-induced ulcers in the chest wall using free and pedicle flapsBo Zhou0Ying Long1Sha Li2Chunliu Lv3Dajiang Song4Yuanyuan Tang5Liang Yi6Zhenhua Luo7Gaoming Xiao8Zan Li9Xiao Zhou10Department of Breast Oncoplastic Surgery, Hunan Cancer Hospital and the Afliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, ChinaTranslational Medicine Centre, Hunan Cancer Hospital and the Afliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, ChinaTranslational Medicine Centre, Hunan Cancer Hospital and the Afliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, ChinaDepartment of Breast Oncoplastic Surgery, Hunan Cancer Hospital and the Afliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, ChinaDepartment of Breast Oncoplastic Surgery, Hunan Cancer Hospital and the Afliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, ChinaDepartment of Breast Oncoplastic Surgery, Hunan Cancer Hospital and the Afliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, ChinaDepartment of Breast Oncoplastic Surgery, Hunan Cancer Hospital and the Afliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, ChinaDepartment of Breast Oncoplastic Surgery, Hunan Cancer Hospital and the Afliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, ChinaDepartment of Thoracic Surgery, Hunan Cancer Hospital and the Afliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, ChinaDepartment of Breast Oncoplastic Surgery, Hunan Cancer Hospital and the Afliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, ChinaDepartment of Breast Oncoplastic Surgery, Hunan Cancer Hospital and the Afliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, ChinaBackground and purposeResection of radiation-induced ulcers often causes full-thickness defects of the chest wall. We retrospectively reviewed and evaluated 17 patients to explore a method of chest wall reconstruction.Materials and methodsA total of 17 breast cancer patients with radiation-induced ulcers were included. Various type of prostheses and flaps were used, results of clinic were evaluated.ResultsSixteen patients had full-thickness defects and one patient had only a soft tissue defect and underwent reconstruction with a pedicle latissimus dorsi (LD) myocutaneous flap. Among all 16 full-thickness defect cases, 15 patients underwent bony thoracic reconstruction using polymesh/3D-printed titanium plates or methyl methacrylate. For soft tissue reconstruction, 13 patients reconstruction using a free deep inferior epigastric perforator (DIEP) flap in combination with a contralateral transverse rectus abdominis myocutaneous (TRAM) flap, and 2 underwent pure free DIEP flap reconstruction. Among all the patients 15 healed with no complications, and 2 patients had delayed healing on the edges of the flaps.ConclusionsDistant pedicle or free flap can used for soft tissue defect coverage, for those severe patients with full-thickness defects and used prostheses, free deep inferior epigastric perforator flap in combination with a contralateral transverse rectus abdominis myocutaneous flap (TRAM + DIEP) would be an applicable choice.https://www.frontiersin.org/articles/10.3389/fsurg.2022.1010990/fullchest wall reconstructionradiation-induced ulcers3Dprintingpedical flapfree flap |
spellingShingle | Bo Zhou Ying Long Sha Li Chunliu Lv Dajiang Song Yuanyuan Tang Liang Yi Zhenhua Luo Gaoming Xiao Zan Li Xiao Zhou Reconstruction of chronic radiation-induced ulcers in the chest wall using free and pedicle flaps Frontiers in Surgery chest wall reconstruction radiation-induced ulcers 3Dprinting pedical flap free flap |
title | Reconstruction of chronic radiation-induced ulcers in the chest wall using free and pedicle flaps |
title_full | Reconstruction of chronic radiation-induced ulcers in the chest wall using free and pedicle flaps |
title_fullStr | Reconstruction of chronic radiation-induced ulcers in the chest wall using free and pedicle flaps |
title_full_unstemmed | Reconstruction of chronic radiation-induced ulcers in the chest wall using free and pedicle flaps |
title_short | Reconstruction of chronic radiation-induced ulcers in the chest wall using free and pedicle flaps |
title_sort | reconstruction of chronic radiation induced ulcers in the chest wall using free and pedicle flaps |
topic | chest wall reconstruction radiation-induced ulcers 3Dprinting pedical flap free flap |
url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1010990/full |
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