ABSTRACT

We present our experience in sternal tumors resections (primary and metastatic) followed by the reconstruction of skeletal defects with a biological mesh pig dermis and the use of titanium cleat. Methods: Two patients were included in this case reports, which were brought to the resection of a tumor and immediately the sternal reconstruction technique was implemented in the chest wall. In the reconstruction, prosthetic material was used with biological pig dermis mesh and a sternal fixation plates (Matrix Synthes Rib^©). Half of the primary tumors of the chest wall, as part of intrinsic bone tumors are malignant, being almost always the most frequent the tumor of the sternum or secondary, appearing as a local recurrence of breast cancer or metastatic disease as other organs. Results: The posoperative course was adequate with no requirement for reintubation, transfer to the intensive care unit, extubated two-day stay and showing excellent results in terms of coverage of vital structures in the thoracic cavity and aesthetic improvement and stabilization of the wall. Conclusions: We propose the use of biological meshes and titanium plates for optimal reconstruction of the chest wall after a complete and partial sternal resection.

KEYWORDS

Chest wall, reconstruction, biological mesh, titanium plates.

REFERENCES

1. McCormack PM. Use of prosthetic materials in chest-wall reconstruction. Assets and liabilities. Surg Clin North Am 1989;69(5):965-976.

2. Moreno-Ramírez H, Villaseñor-Moreno JC, Vázquez-Maldonado AB. Progresión de plasmocitoma óseo a mieloma múltiple y reporte de un caso. Rev Cuba Investig Biomed 2015;34(3):289-297.

3. Gayer G, Yellin A, Apter S, Rozenman Y. Reconstruction of the sternum and chest wall with methyl methacrylate: CT and MRI appearance. Eur Radiol 1998;8(2):239-243.

4. Mansour KA, Anderson TM, Hester TR. Sternal resection and reconstruction. Ann Thorac Surg 1993;55(4):838-842; discussion 843.

5. de Carvalho MV, Rebeis EB, Marchi E. Reconstrução da parede torácica nos defeitos adquiridos. Rev Col Bras Cir 2010;37(1):64-69.

6. Tinajero JCJ, Santillán-Doherty P, Argote-Greene LM, et al. Fracturas traumáticas del esternón : prioridades y estrategia de manejo. Neumol Cir Torax 2009;68(4):151-155.

7. Fernández A. Técnicas de reconstrução da parede torácica. In: Camargo JJ, editor. Tópicos de atualização em cirurgia torácica. São Paulo: SBCT; 2011. p. 520-527.

8. Santillan-Doherty P, Jasso-Victoria R, Sotres-Vega A, et al. Thoracoabdominal wall repair with glutaraldehyde-preserved bovine pericardium. J Investig Surg [Internet]. 1996;9(1):45-55. Available from: http://www.scopus.com/inward/record.url?eid=2-s2.0-9244230116&partnerID=tZOtx3y1

9. Ahmed Z, Mohyuddin Z. Management of flail chest injury: Internal fixation versus endotracheal intubation and ventilation. J Thorac Cardiovasc Surg 1995;110(6):1676-1880.

10. Tanaka H, Yukioka T, Yamaguti Y, et al. Surgical stabilization of internal pneumatic stabilization? A prospective randomized study of management of severe flail chest patients. J Trauma 2002;52(4):727-732; discussion 732.