Narrative review: a multidisciplinary approach to chest wall reconstruction

Area of Science:

• Surgical innovation
• Biomaterials science
• 3D printing in medicine

Background:

• Chest wall reconstruction (CWR) presents significant surgical challenges due to complex anatomy and physiology.
• Successful CWR aims to restore chest wall integrity, eliminate dead space, maintain pulmonary function, and provide adequate soft tissue coverage.
• This review explores contemporary CWR principles, highlighting advancements in biomaterials and surgical techniques.

Purpose of the Study:

• To review modern principles of chest wall reconstruction.
• To emphasize the role of thoracoplastic collaboration in CWR.
• To discuss advances in biomaterials and surgical techniques for CWR.

Main Methods:

• A comprehensive literature search was conducted using PubMed.
• Included studies encompassed randomized controlled trials, retrospective studies, systematic reviews, and case studies.
• The search covered publications from November 1995 to November 2025.

Main Results:

• Hybrid and mesh-based skeletal fixation approaches are popularized by new biomaterials, preserving respiratory function.
• Virtual surgical planning (VSP) and 3D technology are increasingly used for operative planning and custom prosthesis fabrication.
• Microsurgical tissue transfer advances enable reconstruction of large and complex defects, with thoracoplastic approaches being crucial.

Conclusions:

• Chest wall reconstruction is an evolving field with diverse approaches based on defect characteristics and surgeon preference.
• Novel biomaterials and 3D printing offer significant potential for personalized reconstructive strategies.
• Integrated thoracoplastic collaboration between thoracic and plastic surgeons is essential for managing complex CWR cases effectively.