A Novel Approach to Extensive Chest Wall Reconstruction in a Child
Gavin Kane1, David Orr2, Jane Pears3
1Departments of Cardiothoracic Surgery, Plastic Surgery, and Oncology, Children's Health Ireland at Crumlin, Dublin, Ireland.
Insights
Reconstructing large chest wall defects in young children is difficult. This study presents a novel technique using Permacol membrane and a latissimus dorsi flap for successful chest wall reconstruction in a pediatric patient.
Area of Science:
- Pediatric surgery
- Thoracic reconstruction
- Biomaterials in medicine
Background:
- Reconstructing extensive chest wall defects in young children presents unique challenges due to growth considerations and anatomical proportions.
- Traditional rigid prosthetics can impede growth and lead to secondary deformities, while autologous flaps may be insufficient.
- Ewing's sarcoma resection often necessitates complex chest wall reconstruction in pediatric patients.
Abstract:
Reconstruction of extensive chest wall defects is challenging in young children. Rigid prosthetic plates, designed to prevent paradoxic respiration, do not grow with the child and may result in progressive chest and spinal deformity. Also because of the greater proportionate size of the thorax relative to the limbs in young children, extrathoracic soft tissue flaps may be too small for an adequate reconstruction. Here we report reconstruction of a large chest wall defect after resection of a Ewing's sarcoma in a 2-year-old boy using Permacol membrane (Medtronic, Minneapolis, MN) supported by a diagonally translocated seventh rib and covered by a latissimus dorsi flap.
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