Flap reconstruction of the chest wall after oncologic resection

Juho Salo, Erkki Tukiainen


Extensive chest wall resection and chest wall reconstruction are surgically challenging, but also potentially critical for the survival of the patient. For these reasons, careful patient selection is important. A multidisciplinary approach towards patient selection, along with perioperative and post-operative therapy, is essential for achieving the best and earliest possible recovery. The timing and treatment should be individually planned. Chest wall defects can be full-thickness or partial-thickness, while reconstruction can be divided into chest wall stabilization and soft tissue reconstruction with flap. The choice of the flap reconstruction method is based on the location and size of the defect, availability of the local and pedicled options, patient history of previous operations, scars or radiotherapy, and the general condition and prog┬Čnosis of the patient. Pedicled myocutaneous flaps remain the most popular choice for reconstruction of the soft tissue of the chest. However, sometimes the required pedicled or local flaps are inadequate in size and dimension, or are unavailable. In these cases, microvascular reconstruction can be mandatory. This article focuses on soft tissue flap reconstruction of the chest wall after oncological resection.