COMPARATIVE STUDY
JOURNAL ARTICLE
Add like
Add dislike
Add to saved papers

The combination of polytetrafluoroethylene mesh and titanium rib implants: an innovative process for reconstructing large full thickness chest wall defects.

OBJECTIVES: The reconstruction of large full thickness chest wall defect after resection of T3/T4 non-small cell lung cancer (NSCLC) or primary chest wall tumours presents a technical challenge for thoracic surgeons and is a critical factor in determining post-operative outcome. When the defect is large, complications are common with a 27% mean rate of respiratory morbidity.

METHODS: Since 2006, 31 patients underwent reconstruction for wide chest wall defects using titanium implants and strong mesh. The reconstruction was achieved using a layer of polytetrafluoroethylene or a XCM biologic tissue mesh shaped to match the defect and sutured under maximum tension to re-establish the skeletal continuity. The mesh was placed close to the lung and was fixed onto the bony framework and onto the titanium plate. In one case, we used XCM biologic tissue because of a large infected T3 NSCLC. A horizontal titanium rib osteosynthesis system was used to reestablish the rigidity of the thoracic wall by bridging the defect except for one case in which we use a vertical rib osteosynthesis system.

RESULTS: Twenty-six patients underwent a complete R0 resection with the removal of a mean of 4.67 ± 1.5 [3-9] ribs, including the sternum in 14 cases. The mean defect area was 198 ± 91.2 [95-400] cm². Reconstruction required a mean of 2.06 ± 1.1 [1-4] titanium plates. There were two cases of deep wound infection that required surgical removal of the osteosynthesis system in one patient. Only one patient developed a major complication in the form of respiratory failure. There were two postoperative deaths neither of which was directly related to the surgical procedure.

CONCLUSIONS: Our experience and initial results show that titanium rib osteosynthesis in combination with strong biologic or synthetic mesh can easily and safely be used in a one-stage procedure for the reconstruction of major chest wall defects.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app