Institutional Experience with Chest Wall Reconstruction Using Stainless Steel Wires: A Single-Center Case Series Study

OBJECTIVE: Chest wall reconstruction following oncologic resection must achieve structural stability while allowing normal respiratory mechanics. This uncontrolled retrospective case series describes our experience with steel wire-based chest wall reconstruction. The findings are intended to demonstrate the feasibility and safety of this approach. Twisted stainless steel wires (No. 5) offer a low-cost, semi-rigid alternative with passive physiological micro-mobility. MATERIAL AND METHODS: A retrospective case series was conducted in the Department of Thoracic Surgery at Services Hospital in Lahore, Pakistan, from May 2023 to April 2025. Thirty-eight patients who underwent oncologic chest wall resection and reconstruction with twisted stainless steel wires were included. RESULTS: All 38 patients underwent successful wire-based reconstruction; chondrosarcoma was the most frequent cause (21.1% of cases). Mean operative time was 185±56 minutes, and mean blood loss was 295±120 mL. Postoperative pain decreased rapidly (visual analogue scale 4.1 at 24 h → 2.0 at 48 h → 1.7 by day 7). Chest wall recoil was preserved in all patients, with no paradoxical motion or mechanical instability. Functional recovery was excellent: 79% had normal chest expansion on clinical assessment at 1 month, which increased to 94% by 3 months, with complete resolution of dyspnea. The complication rate was low (seroma 2.6%, chronic pain 2.6%); no infections, hematomas, wire failures, or 30-day mortality occurred. CONCLUSION: Twisted stainless steel wires provide a safe, semi-rigid, and cost-effective solution for reconstructing oncologic chest wall defects. This technique preserves respiratory mechanics, ensures functional and cosmetic outcomes, and costs less than 40 USD per case in our setting, making it especially valuable for low- and middle-income countries.