[New reconstruction method for defect of chest wall using composite graft]

Area of Science:

• Surgical Oncology
• Biomaterials Science
• Regenerative Medicine

Background:

• Squamous cell carcinoma of the lung can metastasize to the chest wall, necessitating complex surgical resection and reconstruction.
• Reconstructing chest wall defects, particularly involving ribs, presents significant challenges in maintaining structural integrity and function.

Observation:

• A 64-year-old male patient with left lung squamous cell carcinoma metastasized to the rib underwent chest wall resection.
• A composite graft was created using hydroxyapatite (HAP) filler, a ceramic composed of calcium phosphate apatite hydroxide and 3-calcium phosphate, encased in Dacron (polyethylene terephthalate fiber) fabric.

Findings:

• The artificial rib was constructed by layering Dacron fabric, stitching it to the existing rib with nylon, and packing the cavity with HAP filler.
• Intercostal muscle was incorporated between the Dacron layers, and the artificial rib ends were aligned with the natural rib.
• The reconstruction utilized periosteum and intercostal muscle for graft integration, resulting in good postoperative recovery and no visible or palpable deformation.

Implications:

• This composite graft technique offers a viable and effective method for reconstructing rib defects caused by cancer metastasis.
• The use of hydroxyapatite filler and Dacron fabric provides a durable and aesthetically acceptable solution for chest wall reconstruction.
• Further research into biomaterial-based reconstructions can improve outcomes for patients with extensive thoracic malignancies.