Chest Wall Reconstruction Using Biologic Mesh to Cover Soft Tissue Defects: A Narrative Review

Area of Science:

• Thoracic Surgery
• Biomaterials Science
• Regenerative Medicine

Background:

• Chest wall reconstruction (CWR) addresses functional and aesthetic deficits of the thoracic wall post-resection.
• Biologic mesh is increasingly utilized for soft tissue coverage in CWR procedures.

Purpose of the Study:

• To review the current literature on using biologic mesh for CWR.
• To report on the application of a specific porcine-derived acellular dermal matrix in CWR.

Main Methods:

• A comprehensive literature search was conducted for studies involving biologic mesh in CWR.
• Expert opinion was gathered regarding the use of porcine acellular dermal matrix and muscle flaps for large chest wall defects.

Main Results:

• Biologic mesh is employed in CWR for oncologic resections, trauma, congenital defects, and complex cases (large defects, infection, prior radiation).
• Retrospective studies suggest biologic mesh in CWR is associated with fewer complications, infections, and explantations compared to synthetic mesh.
• Limited data and absence of randomized controlled trials comparing mesh types exist; however, a case study showed successful CWR with porcine acellular dermal matrix and muscle flap reconstruction over 6 years.

Conclusions:

• Literature and expert opinion support the use of biologic mesh in CWR.
• More extensive clinical data are required to guide surgeons in selecting the optimal mesh type based on risks and benefits.