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CC BY-NC 4.0 · Arch Plast Surg 2018; 45(06): 593-597
DOI: 10.5999/aps.2017.00122
Case Report

Complex sternal and rib reconstruction with allogeneic material

Charles Miles Maliska III 
Department of Surgery, University of Oklahoma College of Medicine-Tulsa, Tulsa, OK, USA
,
Robert Lloyd Archer
Saint Francis Heart Hospital, Tulsa, OK, USA
,
Sharon Kaye Tarpley
Tulsa Plastic Surgery, Tulsa, OK, USA
,
Archibald Sanford Miller III
Tulsa Plastic Surgery, Tulsa, OK, USA
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Sternal malunion, or loss, developed after a median sternotomy cannot only be difficult to manage and treat, but also may diminish one’s quality-of-life drastically. The technique presented here represents a multispecialty approach in one stage for the reconstruction of an unstable thoracic cage. The procedure utilized a donated sternum and ribs. The sternum with ribs harvested from a single donor included adipose derived stromal vascular fraction (ADSVF) cells with marrow also from the same donor. Autologous muscle flaps, stabilized with acellular dermal matrix were utilized to provide a robust blood supply to the ADSVF cells and bone grafts. Acellular dermal matrix was used to construct the ribs and stabilize the plugs of stem cells and bone. These procedures, in the hands of multispecialty physicians, have led to several successful reconstructions involving complex chest wall deformities. This surgical intervention was performed in a one stage operation. This represents the first successful complete sternal transplant in a patient with return to normal activities and increased quality-of-life.

Keywords

Reconstructive surgical procedures - Thoracic surgical procedures - Sternum - Adipose derived stromal vascular fraction cells - Fractures, malunited


Publication History

Received: 31 January 2017

Accepted: 07 September 2018

Article published online:
03 April 2022

© 2018. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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