Skip to main content

Free Flaps for Anterior Chest Wall Reconstruction

  • Chapter
  • First Online:
Book cover Plastic and Cosmetic Surgery of the Male Breast

Abstract

Reconstruction of full-thickness chest wall defects usually entails the use of regional pedicled myocutaneous flaps as first-choice option. As defect complexity increases and local options are not available, microsurgical reconstruction is required to transfer reliable and well-vascularized tissues from distant sites. Size, anatomic location, presence of dead spaces, and extent of eventual bone defect should be assessed for proper selection of the flap. Regional recipient vessels should be previously identified and checked in order to consider alternatively the need of extension of distant recipient vessels through arteriovenous (AV) loops or vein graft interposition.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Mansour KA, Thourani VH, Losken A, Reeves JG, Miller JI, Carlson GW, et al. Chest wall resections and reconstruction: a 25-year experience. Ann Thorac Surg. 2002;73(6):1720–5.. discussion 1725–6

    Article  Google Scholar 

  2. Arkudas A, Horch RE, Regus S, Meyer A, Lang W, Schmitz M, et al. Retrospective cohort study of combined approach for trunk reconstruction using arteriovenous loops and free flaps. J Plast Reconstr Aesthetic Surg. 2018;71(3):394–401. https://doi.org/10.1016/j.bjps.2017.08.025.

    Article  Google Scholar 

  3. Philandrianos C, Casanova D, D’journo XB, Thomas PA. Two-stage free anterolateral thigh flap in the management of full-thickness chest wall resection. Eur J Cardiothorac Surg. 2016;50(6):1208–9.

    Article  Google Scholar 

  4. Mathes SJ, Nahai F. Reconstructive surgery: principles, anatomy, and technique, vol. 1. New York: Elsevier—Churchill Livingstone; 1997.

    Google Scholar 

  5. Chan WF, Mardini S. Flaps and reconstructive surgery. London: Saunders; 2009.

    Google Scholar 

  6. Ono J, Takeda A, Akimoto M, Iyoda A, Matsui Y, Satoh Y, et al. Free tensor fascia lata flap and synthetic mesh reconstruction for full-thickness chest wall defect. Case Rep Med. 2013;2013:8–11.

    Article  Google Scholar 

  7. Penington AJ, Theile DR, MacLeod AM, Morrison WA. Free tensor fasciae latae flap reconstruction of defects of the chest and abdominal wall: Selection of recipient vessels. Scand J Plast Reconstr Surg Hand Surg. 1996;30(4):299–305.

    Article  CAS  Google Scholar 

  8. Di Candia M, Wells FC, Malata CM. Anterolateral thigh free flap for complex composite central chest wall defect reconstruction with extrathoracic microvascular anastomoses. Plast Reconstr Surg. 2010;126(5):1581–8.

    Article  Google Scholar 

  9. Gazyakan E, Engel H, Lehnhardt M, Pelzer M. Bilateral double free-flaps for reconstruction of extensive chest wall defect. Ann Thorac Surg. 2012;93(4):1289–91. https://linkinghub.elsevier.com/retrieve/pii/S0003497511019412

    Article  Google Scholar 

  10. Skoracki RJ, Chang DW. Reconstruction of the chest wall and thorax. J Surg Oncol. 2006;94(6):455–65. https://doi.org/10.1002/jso.20482.

    Article  PubMed  Google Scholar 

  11. Netscher DT, Baumholtz MA. Chest reconstruction: I. Anterior and anterolateral chest wall and wounds affecting respiratory function. Plast Reconstr Surg. 2009;124(5):240–52.

    Article  Google Scholar 

  12. Cordeiro PG, Santamaria E, Hidalgo D. The role of microsurgery in reconstruction of oncologic chest wall defects. Plast Reconstr Surg. 2001;108(7):1924–30. http://www.ncbi.nlm.nih.gov/pubmed/11743378

    Article  CAS  Google Scholar 

  13. Lee CJ, Kim CW, Kwak IH, Gil MS, Bang YH, Lee SI. The use of omentum as a free flap to reconstruct the upper portion of the mediastinum without a substernal tract. Ann Plast Surg. 2001;47(1):93–5.

    Article  CAS  Google Scholar 

  14. Reichenberger MA, Harenberg PS, Pelzer M, Gazyakan E, Ryssel H, Germann G, et al. Arteriovenous loops in microsurgical free tissue transfer in reconstruction of central sternal defects. J Thorac Cardiovasc Surg. 2010;140(6):1283–7.

    Article  Google Scholar 

  15. Luan A, Galvez MG, Lee GK. Flow-through omental flap to free anterolateral thigh flap for complex chest wall reconstruction: case report and review of the literature. Microsurgery. 2016;36(1):70–6. https://doi.org/10.1002/micr.22444.

    Article  PubMed  Google Scholar 

  16. Staruch RMT, Rouhani MJ, Ellabban M. The surgical management of male breast cancer: time for an easy access national reporting database. Ann Med Surg. 2016;9:41–9.

    Article  Google Scholar 

  17. Engel H, Pelzer M, Sauerbier M, Germann G, Heitmann C. An innovative treatment concept for free flap reconstruction of complex central chest wall defects - The cephalic-thoraco-acromial (CTA) loop. Microsurgery. 2007;27(5):481–6.

    Article  Google Scholar 

  18. Salgado CJ, Moran SL, Mardini S. Flap monitoring and patient management. Plast Reconstr Surg. 2009;124(6 Suppl):e295–302.

    Article  CAS  Google Scholar 

  19. Merritt RE. Chest wall reconstruction without prosthetic material. Thorac Surg Clin. 2017;27(2):165–9. https://doi.org/10.1016/j.thorsurg.2017.01.010.

    Article  PubMed  Google Scholar 

  20. JTK S, Tukiainen EJ. Oncologic resection and reconstruction of the chest wall. Plast Reconstr Surg. 2018;142:536–47. http://insights.ovid.com/crossref?an=00006534-201808000-00036

    Article  Google Scholar 

  21. Cherubino M, Maggiulli F, Pellegatta I, Valdatta L. Free gracilis flap for chest wall reconstruction in male patient with Poland syndrome after implant failure. Indian J Plast Surg. 2016;49(2):2016–8.

    Google Scholar 

  22. Basta MN, Fischer JP, Lotano VE, Kovach SJ. The thoracoplastic approach to chest wall reconstruction. Plast Reconstr Surg. 2014;134(6):959e–67e.

    Article  CAS  Google Scholar 

Download references

Acknowledgments

Conflict of Interests: No conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Francesca Toia .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Toia, F., Cajozzo, M., Matta, D., Cordova, A. (2020). Free Flaps for Anterior Chest Wall Reconstruction. In: Cordova, A., Innocenti, A., Toia, F., Tripoli, M. (eds) Plastic and Cosmetic Surgery of the Male Breast. Springer, Cham. https://doi.org/10.1007/978-3-030-25502-2_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-25502-2_15

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-25501-5

  • Online ISBN: 978-3-030-25502-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics