A new option of reconstruction after extensive chest wall resection

Chest wall reconstruction plays an important role in the outcomes of chest wall resection. However, there being a huge variety of materials at disposable, the best option has not yet been well defined. The Vitagraft® is a synthetic and absorbable material, that works as an osteoinduction and osteoconduction for bone regeneration. It consists of a β-phase Tricalcium Phosphate Ceramic (β-TCP) and the Polylactic Glycolic Acid Polymer (PLGA). Therefore, this study intends to assess the safety of Vitagraft® use in the chest wall.

A prospective study, in which the patient's chest was reconstructed with Vitagraft®. Each patient was followed after the procedure for at least three months. The following variables were considered: KPS, ECOG, preoperative treatment, defect size, myocutaneous flap, the time between surgeries, complications, and mortality.

Eight resections were performed due to tumor findings. One reconstruction was a treatment for sternal cleft, another for Poland's syndrome, and finally as a consequence of late sternal dehiscence. Primary closure was performed in 63.6 % of the patients. Vitagraft® was used in association with mesh in eight cases. Reoperation was required in two cases, and prosthesis removal for one of them. Respiratory failure and major systemic complications were not evidenced.

In the present study, the first to assess Vitagraft® in chest wall reconstruction, the second operation was necessary for 28 %, and removal was mandatory for 14 %. Until now, chest postoperative tomography has been showing good prosthesis biocompatibility. The authors need further details about the ossification time especially relating to the size of the resection.