Perforator Flaps Covering Alloplastic Materials in Full-Thickness Chest Wall Defects Reconstruction: A Safe Option?

Area of Science:

• Plastic Surgery
• Thoracic Surgery
• Reconstructive Surgery

Background:

• Large full-thickness chest wall defects necessitate alloplastic materials for stability and flaps for soft-tissue coverage.
• Perforator flaps are often avoided due to concerns about inadequate vascularization over inert materials.

Observation:

• This study evaluated the use of perforator flaps with alloplastic materials in four patients with full-thickness chest wall defects.
• Reconstructions utilized double Marlex mesh or Goretex patches combined with deep inferior epigastric artery perforator or lumbar artery perforator flaps.

Findings:

• The combination of perforator flaps and alloplastic materials (Marlex mesh, acrylic cement, or Goretex) yielded encouraging results in chest wall reconstruction.
• This technique provided both chest wall stability and adequate soft-tissue coverage.

Implications:

• Perforator flaps in conjunction with alloplastic materials represent a viable and reliable option for complex full-thickness chest wall defect reconstruction.
• This approach may overcome limitations associated with traditional methods and minimize donor-site morbidity.