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Arch Hand Microsurg > Volume 24(1); 2015 > Article
Archives of Hand and Microsurgery 2015;24(1):28-31.
Published online May 30, 2015.
DOI: https://doi.org/10.15596/ARMS.2015.24.1.28   
Preserved Respiratory Function after Reconstruction of a Large Chest Wall Defect
Yu Jin Kim*, Yoon Ji Kim, and Jae-Ik Lee1
1Department of Plastic and Reconstructive Surgery, Gachon University Gil Medical Center, Incheon, Korea. pseugene@gilhospital.com
2Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Incheon, Korea.
Received: 11 December 2014   • Revised: 19 December 2014   • Accepted: 26 December 2014
Abstract

A case report of a patient who developed radiation-induced sarcoma in the left chest wall is presented. The patient had partial mastectomy and adjuvant radiation therapy (total dose, 5,220 cGy) and chemotherapy. Five years later, she visited with rapidly growing mass with central ulceration in the irradiated chest wall. The mass was diagnosed as malignant fibrous histiocytoma. The chest wall mass resected en bloc (23×18 cm) including five consecutive ribs. After the defected thoracic cage was reinforced using a polytetrafluoroethylene patch, omental flap and split thickness skin graft was done for soft tissue coverage. We applied negative pressure wound closer system for effective suction of omeantal exudate. The wound healed without complications. The patient suffered no perioperative pulmonary complications. Pulmonary function tests showed no significant changes. Each of Gore-Tex, omental flap, negative pressure wound therapy and skin graft is widely used method. However, If these methods are used in combination, we can reconstruct the large defect of chest wall including multiple ribs without any repiratory function problems.

Key Words: Sarcoma, Radiation-induced, Respiratory function tests, Thoracic wall, Omentum
 


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