Physical Address
304 North Cardinal St.
Dorchester Center, MA 02124
Lateral Chest Reconstruction
Clinical Presentation
A 74-year-old White female suffered a lateral chest wound and had a partial breast defect secondary to wound debridement, complicated by the previous minimally invasive right lobectomy. Apparently, she had a seroma formation in the area, which had been managed by the thoracic surgery service. The plastic surgery service was asked to provide soft tissue coverage for the wound and to facilitate healing of the complicated wound. The lateral chest wound also involved part of the axilla and the superior lateral quadrant of the breast ( Fig. 22.1 ). Prior to the procedure the wound had been treated with local wound care.
Operative Plan and Special Considerations
Additional debridement was planned to excise all fibrotic tissues around and deep to the open wound. Such debridement should be done to healthy and normal-looking tissue either around or at the base of the wound. Attention should be paid to avoid injuries to neurovascular structures in the axilla. Because of the location and size of the soft tissue defect after debridement, a pedicled latissimus dorsi myocutaneous flap can be selected to cover this wound in one stage. The flap can be elevated from the patient’s right back and tunneled to the defect without any difficulty. In addition, a portion of the breast defect can be reconstructed at the same time. If the skin paddle of the flap is not too wide, the flap donor site can also be closed primarily.
You're Reading a Preview
Become a Clinical Tree membership for Full access and enjoy Unlimited articles
If you are a member. Log in here