Repair of pectus excavatum using a substernal metal strut within a Marlex envelope

In a retrospective review, 82 children aged 3 to 16 years who had repair of pectus excavatum from 1963 to 1987 were divided into three groups according to type of repair: those without a metal substernal strut, those with a metal substernal strut, and those with a metal substernal strut within a Marlex envelope. In group 1 (n = 50) there were five recurrences; in group 2 (n = 18) and group 3 (n = 14) there were no recurrences. There was migration of the substernal strut in eight patients in group 2 (44%) and three patients in group 3 (21%). There were minor wound infections in groups 1 and 2 only. There were no deaths. Results of this study suggest that the use of a substernal strut significantly reduced recurrence and that the addition of a Marlex envelope around the strut reduced migration of the strut with no associated complications.