Innovative Technique of Chest Wall Reconstruction After Extensive Tumor Ablation Surgery

Correspondence: Vijay Kumar (E-mail: [e-mail])

Abstract

Background Chest wall reconstruction is among the most demanding procedures in reconstructive surgery. Large defects typically involve multiple anatomical components—skin, bone, cartilage, and pleural or mediastinal lining—each of which requires separate and functionally appropriate reconstruction. Conventional methods include autologous techniques, such as regional or free osteocutaneous flaps, and alloplastic techniques, employing materials like titanium plates, stainless steel mesh, Medpor, or custom 3D-printed prostheses. While effective, these methods can be technically complex, time-consuming, and associated with significant donor-site morbidity.

Case Presentation I report a patient with recurrent chest wall chondrosarcoma requiring wide local excision. The resection resulted in a full-thickness defect involving the sternum, ribs, and precordial lining. Traditional reconstruction using free flaps was deemed extensive and time-consuming. Therefore, an alternative strategy was employed.

Surgical Technique Reconstruction was performed using an acrylic implant molded to replace the resected sternum and ribs, providing rigid bony stability. The implant was reinforced with a pectoralis major myocutaneous flap, which offered durable soft-tissue coverage and protection of mediastinal structures. This combination allowed restoration of chest wall contour, skeletal support, and reliable vascularized cover.

Results The reconstruction was successful, ensuring stability and adequate respiratory mechanics. Operative time was significantly reduced compared to osteocutaneous free flap procedures, which typically require 8 to 10 hours and may involve two flaps for large defects. Postoperative recovery was uneventful, and functional as well as aesthetic outcomes were satisfactory.

Conclusion Chest wall reconstruction is inherently challenging due to its multi-component nature. Traditional methods often require complex and prolonged microsurgical procedures. Our case highlights a safe, effective, and less time-consuming alternative using an acrylic implant combined with a regional myocutaneous flap. This novel approach provides a practical solution for large chest wall defects and, to our knowledge, has not been previously reported.

Keywords: chest wall reconstruction, acrylic implant, myocutaneous flap, chondrosarcoma

Publication History

Article published online:
10 November 2025