Reconstruction of multiple digital defects by temporary syndactylization using a lateral arm free flap

초록

Background: Chest wall defects can occur after the resection of malignancies. It is essential to reconstruct the chest wall to cover vital tissues and prevent paradoxical movement. Objective: We analyzed the results and complications of the chest wall reconstructions followed by malignant tumor resection. Material and method(s): From 2013 to 2022, we reviewed medical records of patients who received chest reconstruction after cancer resection. The patient's demographic data, types of tumor, chest wall reconstruction, and complications. Results: Of the 13 patients, 12 had primary tumors and 1 had metastatic carcinoma. Six cases were sarcomas, three were invasive breast cancers, and three were squamous cell carcinomas. The skeletal reconstruction was performed on 6 patients. The types of flaps were 8 pedicled latissimus dorsi (LD) myocutaneous flaps, 2 pectoralis major myocutaneous flaps, 2 vertical rectus abdominis myocutaneous free flaps and 1 LD free flap. All were one staged reconstruction. Most complications were atelectasis, with no flail chests. Conclusion: In case of accompanying multiple ribs and sternal defects, skeletal reconstruction is needed to prevent paradoxical chest wall motion. The reconstruction method should be selected according to defect size and location. We recommend the reconstruction algorithm for chest wall defects due to malignant tumor resection.