Reconstruction of the chest wall. Procedures and nursing care

Use of prosthetic materials in chest-wall reconstruction. Assets and liabilities

Sparked by the experience during war time, our knowledge of how to handle chest-wall defects has matured with the decades since the 1940s. Techniques are now available for reconstruction of large areas of the chest wall. The materials are readily available and can be adapted to fit any size and shape of defect. The disadvantages are few and correctable. This technique has been used to restore chest continuity in patients whose tumors were resected for cure. It has also been used palliatively for patients with bleeding, ulcerative, or infected tumors of the chest wall and in those with known metastases elsewhere. Removing the malodorous mass from the chest wall provides excellent palliation and should be offered to patients to improve their quality of survival.

Latissimus dorsi muscle-musculocutaneous flap in chest-wall reconstruction

The latissimus dorsi is a versatile muscle that can be employed in a variety of situations requiring chest-wall reconstruction. Its anatomy is predictable and has within it flexibility for transposition to a number of locations based on its standard or reverse arcs of rotation. It can be transposed with a skin island, and its length and bulk can be used effectively to provide durable coverage for anterior or posterior defects. These factors make the latissimus dorsi an excellent choice for the reconstruction of complex chest-wall defects.