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A simplified strategy for chest wall reconstruction: locoregional flaps as a reliable alternative in resource-limited
Tian Yang1, Zhongxin Liu2, Shaoyou Wang3
1Department of Thyroid and Breast Surgery, Comprehensive Breast Health Center；Institute of Breast Oncology, Lishui University Medical College, The First Affiliated Hospital of Lishui University, Lishui People's Hospital, Lishui Hospital of Wenzhou Medical University, 15 Dazhong Road, Lishui, Zhejiang, 323000, China. 1220765386@qq.com.
Background:
The reconstruction of complex chest wall defects resulting from advanced breast cancer poses a significant challenge in facilities lacking microsurgical expertise. This study aims to present a simplified, reliable, and easily reproducible locoregional flap strategy for these scenarios.
Methods:
A retrospective analysis was conducted on four female patients who underwent immediate chest wall reconstruction following resection for locally advanced breast cancer between 2020 and 2022. A standardized protocol employing regional flaps, selected based on defect size and location, was used. Core principles included meticulous preservation of the blood supply, tension-free closure, and adequate drainage.
Results:
The chest wall defects ranged from 8 × 8 cm to 26.3 × 21.5 cm. The flaps used included lateral thoracic and pedicled abdominal flaps. All flaps survived completely (4/4). One patient with a massive defect experienced minor superficial skin compromise (approx. 3 cm) at the distal flap edge, which healed with conservative management. All defects were successfully addressed in a single stage, resulting in high patient satisfaction with the chest wall contour.
Conclusion:
This simplified locoregional flap strategy, which does not require microvascular anastomosis, is feasible strategy and has a short learning curve. Despite the limited number of cases, it is particularly suitable for promotion in primary hospitals or resource-limited settings, offering a practical solution for reconstructing complex chest wall defects in advanced breast cancer patients.
