RESUMO
Objective: To determine the outcomes of the use of the Latissimus Dorsi Flap for the Reconstruction of Complex Chest Wall Defects: Is a polypropylene mesh and a flap enough? Study Design: Descriptive case series. Place and Duration of Study: The study was conducted in the department of Plastic and Reconstructive Surgery Shifa International Hospital Islamabad, over a period of 5 years between Jan 2012 and Dec 2016
Material and Methods: All patients with chest wall defects, post tumor resection diagnosed on tissue biopsy, trauma, osteoradionecrosis and infection were included in this study. The chest wall was reconstructed with a polypropylene mesh and the latissimus dorsi flap. All the patients with tumors were discussed in multidisciplinary team meeting. Patients with post coronary artery bypass surgery wounds were excluded from this study. Demographic data including age, sex, histopathological diagnosis of disease and other outcomes were studied
Results: Total 22 patients were included in this study over a period of 05 years, 16 patients with tumors. Age range was 12 to 63 years. Mean follow up time was 3 years. Six patients developed postoperative complications: one patient had partial skin graft loss at the recipient site. Two patients developed partial wound dehiscence one at the donor area and other at the flap inset site. One patient had partial distal flap loss and graft loss at donor area. There was no mortality in our series
Conclusion: Our study revealed that the polypropylene mesh covered with the latissimus dorsi myocutaneous flap is adequate for skeletal stabilization of composite chest wall defects achieving satisfactory functional and aesthetic results
RESUMO
Objective: To determine the outcomes of free tissue transfer for large scalp and forehead defects reconstruction. Study Design: A descriptive case series. Place and Duration of Study: The study was carried out at Plastic surgery department, Shifa International Hospital Islamabad, over a period of 5 years from Mar 2011 to Feb 2016
Material and Methods: All the patients who underwent scalp reconstruction for soft tissue or composite defects greater than 6 cm 2 during the period of 5 years were included in the series and were followed post operatively for 6 months. The patient's demographic data, medical history, surgical history, comorbidities, age, and gender were also analyzed. Indications for surgical intervention included cutaneous malignancy of the scalp, bony tumors, vascular lesions and traumatic tissue loss requiring reconstruction
Results: A total of 20 patients [60% female and 40% male] with mean age of 38.75 years [SD=14.44], who underwent a reconstructive surgery for scalp defect, were assessed. The scalp defect were secondary to tumor resection [n=10; 50%], post-traumatic wounds [n=5, 25%] and resection of vascular malformations [n=5, 25%]. Free flaps used for reconstruction were: Antero Lateral Thigh Free Flap [ALTF] [n=8; 40%], Radial Forearm Free Flap [RFFF] [n=6, 30%], free latissimus dorsi [n=4, 20%] and Transversus Abdominis muscle [TRAM] flap [n=2, 10%]
Conclusion: Scalp and forehead defects, if treated adequately, can heal with stable and aesthetically acceptable results and flap selection should be individualized according to the defects, patient's factors and availability of particular flap