ADEQUATE CHEST WALL RECONSTRUCTION FOR COMPOSITE DEFECTS ACHIEVED BY SOFT TISSUE FLAP +MESH ONLY

ABSTRACT Objective: To evaluate our results of composite chest wall reconstruction after malignant tumor resection in which bony stabilization was achieved with polypropylene mesh and soft tissue coverage with pedicled myocutaneous flaps. Study Design: This is a cross-sectional study. Place and duration of Study: Shifa International Hospital from 1st January 2020 to 31st December 2023. Methodology: The study includes 17 patients who underwent composite chest wall resections for malignant tumors. Bony stabilization was done by polypropylene mesh and for soft tissue defect pedicle latissimus dorsi and transverse rectus abdominis flaps were used. Patients were assessed for tumor type, location, resected ribs, flap type, hospital stay, any minor or major complications postoperatively. Results: Out of 17 patients, 11 (64.7%) were females and 6(35.3%) were males. The causes of composite chest wall defect were 12 primary chest wall tumors (70.6%) and 5 breast carcinoma (29.4%). Ribs along with sternum were resected in 1 case and ribs only in 16 patients. The average number of ribs resected were 3.3(ranging from 3-5). The average chest wall defect after wide resection was 161.1cm2 (ranging from 88cm -228 cm2). Mean postoperative hospital stay was 7.41 days (range 5-12 days). No perioperative mortality was addressed. Conclusion: Synthetic polypropylene mesh alone can be used for composite chest wall defects as it has less infection rate than rigid prosthesis, easy to use, safe and most importantly cost effective for the patient.