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Microsurgical Chest Wall Reconstruction with Abdominal Flaps for Large Full-Thickness Oncologic Defects
Shiuan Shyu1, David Chon-Fok Cheong1,2,3, Chia-Fang Chen1,2,3
1Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.
Seminars in Plastic Surgery
|April 27, 2026
Summary
Microsurgical reconstruction using abdominal flaps effectively addresses large chest wall defects after cancer surgery. This technique provides durable, well-vascularized tissue for complex oncologic reconstructions.
Area of Science:
- Oncology
- Plastic Surgery
- Microsurgery
Background:
- Extensive chest wall defects after oncologic resection pose significant reconstructive challenges.
- Large, vessel-depleted defects require robust and reliable reconstructive solutions.
Purpose of the Study:
- To evaluate the efficacy of microsurgical reconstruction using abdominal-based flaps for large full-thickness chest wall defects.
- To present outcomes in patients with oncologic chest wall resections.
Main Methods:
- Retrospective review of eight patients undergoing oncologic chest wall resection and microsurgical reconstruction.
- Utilized abdominal-based flaps including pedicled transverse rectus abdominis myocutaneous (TRAM) and free deep inferior epigastric artery perforator (DIEP) flaps.
- Reconstruction addressed defect sizes ranging from 224 to 384 cm².
Main Results:
- Eight patients with breast, lung cancer, or desmoid fibromatosis underwent reconstruction for curative or palliative intent.
- All abdominal flaps were successfully transferred with minimal complications.
- Flap sizes ranged from 28 cm × 13 cm to 36 cm × 14 cm.
Conclusions:
- Microsurgical chest wall reconstruction with abdominal flaps is a durable option for complex defects.
- These flaps offer substantial volume, robust vascularity, and design flexibility.
- This technique provides a reliable solution for challenging oncologic chest wall reconstructions.
