Skip to main content
SpringerLink
Log in

Pedicled Flaps for Anterior Chest Wall Reconstruction

  • Chapter
  • First Online:
Plastic and Cosmetic Surgery of the Male Breast

  • 554 Accesses

Abstract

Pedicled local or regional flaps are the main reconstructive tool for chest wall defects. Muscle or musculocutaneous flaps are most commonly used, with the latissimus dorsi and the pectoralis major being the workhorse flaps. However, perforator flaps have recently affirmed even for reconstruction of complex defects. A thorough knowledge of the vascular anatomy of the thorax and of the patient’s medical history is essential for selecting the best reconstructive option. The defect location, size, and depth as well as previous surgeries in the same area are the main issues affecting the reconstructive choices.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Althubaiti G, Butler CE. Abdominal wall and chest wall reconstruction. Plast Reconstr Surg. 2014;133(5):688–701.

    Article  Google Scholar 

  2. Netscher DT, Baumholtz MA. Chest reconstruction: I. Anterior and anterolateral chest wall and wounds affecting respiratory function. Plast Reconstr Surg. 2009;124(5):240–52.

    Article  Google Scholar 

  3. Basta MN, Fischer JP, Lotano VE, Kovach SJ. The thoracoplastic approach to chest wall reconstruction. Plast Reconstr Surg. 2014;134(6):959e–67e.

    Article  CAS  Google Scholar 

  4. Luan A, Galvez MG, Lee GK. Flow-through omental flap to free anterolateral thigh flap for complex chest wall reconstruction: case report and review of the literature. Microsurgery. 2016;36(1):70–6.

    Article  Google Scholar 

  5. Clemens M, Evans K, Mardini S, Arnold P. Introduction to chest wall reconstruction: anatomy and physiology of the chest and indications for chest wall reconstruction. Semin Plast Surg. 2011;25(01):005–15.

    Article  Google Scholar 

  6. Aubá C, Cabello Á, Garciá-Tutor E, Vila A, Qiu SS, Torre W. Perforator flaps covering alloplastic materials in full-thickness chest wall defects reconstruction: a safe option? Plast Reconstr Surg. 2017;5(5):2–4.

    Google Scholar 

  7. Losken A, Thourani VH, Carlson GW, Jones GE, Culbertson JH, Miller JI, et al. A reconstructive algorithm for plastic surgery following extensive chest wall resection. Br J Plast Surg. 2004;57(4):295–302.

    Article  CAS  Google Scholar 

  8. Momeni A, Kovach SJ. Important considerations in chest wall reconstruction. J Surg Oncol. 2016;113(8):913–22.

    Article  Google Scholar 

  9. Patten DK, Sharifi LK, Fazel M. New approaches in the management of male breast cancer. Clin Breast Cancer. 2013;13(5):309–14.

    Article  Google Scholar 

  10. Mathes SJ, Nahai F. Reconstructive surgery: principles, anatomy, and technique, vol. 1. New York: Elsevier—Churchill Livingstone; 1997.

    Google Scholar 

  11. Fisher J, Bostwick J, Powell RW. Latissimus dorsi blood supply after thoracodorsal vessel division: the serratus collateral. Plast Reconstr Surg. 1983;72(4):502–11.

    Article  CAS  Google Scholar 

  12. Eburdery H, Grolleau JL, Berthier C, Bertheuil N, Chaput B. Management of large sternal wound infections with the superior epigastric artery perforator flap. Ann Thorac Surg. 2016;101(1):375–7.

    Article  CAS  Google Scholar 

  13. Hultman CS, Culbertson JH, Jones GE, Losken A, Kumar AV, Carlson GW, et al. Thoracic reconstruction with the omentum: indications, complications, and results. Ann Plast Surg. 2001;46(3):242–9.

    Article  CAS  Google Scholar 

  14. Chittithavorn V, Rergkliang C, Chetpaophan A, Simapattanapong T. Single-stage omental flap transposition: modality of an effective treatment for deep sternal wound infection. Interact Cardiovasc Thorac Surg. 2011;12(6):982–6.

    Article  Google Scholar 

  15. Lee CJ, Kim CW, Kwak IH, Gil MS, Bang YH, Lee SI. The use of omentum as a free flap to reconstruct the upper portion of the mediastinum without a substernal tract. Ann Plast Surg. 2001;47(1):93–5.

    Article  CAS  Google Scholar 

  16. Krishnamurthy A. A novel clinical application of the classical Bakamjian flap in the reconstruction of a sternal chondrosarcoma defect. Indian J Surg. 2015;77(Suppl 3):1444–6.

    Article  Google Scholar 

  17. Merritt RE. Chest wall reconstruction without prosthetic material. Thorac Surg Clin. 2017;27(2):165–9.

    Article  Google Scholar 

  18. Harati K, Kolbenschlag J, Behr B, Goertz O, Hirsch T, Kapalschinski N, et al. Thoracic wall reconstruction after tumor resection. Front Oncol. 2015;5(October):1–10.

    Google Scholar 

  19. Sanna S, Brandolini J, Pardolesi A, Argnani D, Mengozzi M, Dell’Amore A, et al. Materials and techniques in chest wall reconstruction: a review. J Vis Surg. 2017;3:95.

    Article  Google Scholar 

  20. Seder CW, Rocco G. Chest wall reconstruction after extended resection. J Thorac Dis. 2016;8(Suppl 11):S863–71.

    Article  Google Scholar 

  21. Sandler G, Hayes-Jordan A. Chest wall reconstruction after tumor resection. Semin Pediatr Surg. 2018;27(3):200–6.

    Article  Google Scholar 

  22. Florczak A-S, Chaput B, Herlin C, Rousseau P, Watier E, Bertheuil N. The use of pedicled perforator flaps in chest reconstruction. Ann Plast Surg. 2018;81(4):487–94.

    Article  CAS  Google Scholar 

  23. Kannan RY. The internal mammary artery perforator flap and its subtypes in the reconstruction of median sternotomy wounds. J Thorac Cardiovasc Surg. 2016;152(1):264–8.

    Article  Google Scholar 

  24. Kou XJ, Liang XH, Bai YL, Lu FQ, Feng YR, Han DM, et al. Design of internal mammary artery perforator island pedicle flap with digital subtraction angiography for head and neck reconstruction. Int J Clin Exp Med. 2016;9(10):19122–9.

    Google Scholar 

  25. Kou X, Liang X, Wang B, Feng Y, Chen X, Han D. Original Article A new method to locate internal mammary artery perforator: by DSA and the metal pins on the chest. Int J Clin Exp Pathol. 2016;9(11):11238–45.

    Google Scholar 

  26. Salo JTK, Tukiainen EJ. Oncologic resection and reconstruction of the chest wall: a 19-year experience in a single center. Plast Reconstr Surg. 2018;142:536–47.

    Article  CAS  Google Scholar 

  27. Bentz ML, Chen JT, Maloney JD, Shulzhenko N, Bonneau LA, Castro F, et al. A twelve-year consecutive case experience in thoracic reconstruction. Plast Reconstr Surg. 2016;4(3):e638.

    Google Scholar 

Download references

Acknowledgments

Conflict of Interests: No conflict of interest.

Author information

Authors and Affiliations

  1. Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy

    Francesca Toia, Tiziana Roggio, Daniela Canzonieri & Adriana Cordova

Authors
  1. Francesca Toia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tiziana Roggio
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Daniela Canzonieri
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Adriana Cordova
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Francesca Toia .

Editor information

Editors and Affiliations

  1. Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Palermo, Italy

    Adriana Cordova

  2. Plastic Surgery, Azienda Ospedaliero Universitaria Caregg, Florence, Italy

    Alessandro Innocenti

  3. Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Palermo, Italy

    Francesca Toia

  4. UOC of Plastic and Reconstructive Surgery, Department of Oncology, AOU Policlinico Paolo Giaccone, Palermo, Italy

    Massimiliano Tripoli

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Toia, F., Roggio, T., Canzonieri, D., Cordova, A. (2020). Pedicled Flaps for Anterior Chest Wall Reconstruction. In: Cordova, A., Innocenti, A., Toia, F., Tripoli, M. (eds) Plastic and Cosmetic Surgery of the Male Breast. Springer, Cham. https://doi.org/10.1007/978-3-030-25502-2_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-25502-2_14

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-25501-5

  • Online ISBN: 978-3-030-25502-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation