The Use of Fascia Lata in the Reconstruction of Chest Wall Defects: Is It Effective

Abstract

Introduction: Chest wall defects could be encountered after chest wall resection for chest wall tumors or resection of pleural or pulmonary tumors invading chest wall. Moreover, they could result from chest trauma. Chest wall reconstruction can be difficult and challenging for the thoracic surgeon. Different techniques and materials were introduced to carry out reconstruction of chest wall defects. Synthetic materials have been associated with some disadvantages. Fascia lata harvested from the thigh of the patient could replace the synthetic materials for chest wall reconstruction therefore avoiding their disadvantages. Aim: The aim of this study was to determine the efficacy and outcome of the use of fascia lata in the reconstruction of chest wall defects. Patients and methods: Retrospective revision of the files of the patients who underwent chest wall reconstruction for chest wall defects using fascia lata at Cardiothoracic Surgery Department at Alexandria University, Egypt during the period (January 2003- December 2008) was done. Results: Ninety patients (13 males and 6 females) underwent chest wall reconstruction of chest wall defects using fascia lata. Age ranged between 22-75 (49.7±13.7) years. The diameter of chest wall defects was between 5-17 cm. The time range for harvesting fascia lata was 14-20 (15.8±2.6) minutes. Average of postoperative hospital stay was 12±13.1 days. The complication that was encountered at site of harvesting of fascia lata was seroma formation that needed to be aspirated (10.5%). Stability was achieved in 78.9% of patients while small segment of paradoxical movement were encountered in 21.1%. Conclusion: In conclusion, reconstruction of chest wall defects using free graft of fascia lata was found to be safe with low rate of complications. It avoids the risk of infection that encountered with the use of synthetic materials. The stability provided to the chest wall after reconstruction with fascia lata was found to be dependent on the size and site of the chest wall defect. Moreover, it was found that fascia lata could provide acceptable stability for reconstructed chest wall defects that is more pronounced few weeks later following surgery.