Abstract
A large full-thickness chest wall defect over 10 cm in diameter requires skeletal reconstruction and soft tissue coverage. Use of various flaps for soft tissue coverage was previously reported, but en bloc resection in each case affects these flap pedicles and sizes. We present a case of a 74-year-old man with a soft tissue tumor involving the left lateral chest wall. We performed an en block resection and skeletal reconstruction using a mesh, free tensor fascia lata (TFL) flap for soft tissue coverage. This procedure could be performed in one position. A fixed fascia lata of the flap was also useful for tight reconstruction with the mesh. We suggest that free TFL and/or anterior lateral thigh flap is a useful technique to reconstruct anterior to posterior lateral chest wall defects.
Highlights
For a chest wall reconstruction, it is necessary to do a skeletal and soft tissue reconstruction
Full-thickness chest wall reconstruction may be performed with a myocutaneous flap such as the latissimus dorsi or rectus abdominis [5], but the pedicles of these flaps could be resected with the tumor in some cases
The selection of material for skeletal reconstruction and the flap for soft tissue coverage is of utmost importance in chest wall reconstruction
Summary
For a chest wall reconstruction, it is necessary to do a skeletal and soft tissue reconstruction. Management of the pleural cavity is important to decrease the rate of postoperative complications and mortality [1]. The availability of prosthetic materials influences the surgeon’s choice, and complications are sometimes caused by those materials [2,3,4]. Using flaps to repair a full-thickness defect depends on the reconstruction portion and size of the chest wall defect. We report a full-thickness chest wall reconstruction by free tensor fascia lata (TFL) flap, using a fascia lata and mesh for skeletal support for a patient with malignant fibrous histiocytoma (MFH) involving the chest wall
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