Acellular dermal matrix and bone cement sandwich technique for chest wall reconstruction

Heo, Chan Yeong; Kang, Byungkwon; Jeong, Jae Hoon; Kim, Kwhanmien; Myung, Yujin

doi:10.5999/aps.2021.01067

Cited by 4 publications

(14 citation statements)

References 10 publications

(18 reference statements)

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“…One of the most common composites is the combination of polymethylmethacrylate in two layers of the propylene mesh, placed as a “sandwich” ( 21 ), but several materials could be mixed, such as rigid+non-rigid synthetic prostheses, autologous + synthetic prostheses, xenograft + synthetic prostheses, and so on. The report by Heo et al ( 25 ) is an example of how rigid and non-rigid synthetic prosthetic meshes along with xenografts could be combined at the same time: in six patients, after the removal of the chest wall tumor, the visceral pleura was repaired with Gore-Tex; the first layer of the acellular dermal matrix was placed on Gore-Tex, then bone cement was used as a substitute for ribs, and finally the second layer of the acellular dermal matrix was sutured with the first one, preventing the contact of the cement with the soft tissue. No major complications occurred, and no perioperative mortality was reported.…”

Section: Discussionmentioning

confidence: 95%

Chest wall reconstruction in benign and malignant tumors with non-rigid materials: An overview

Colella¹,

Brandimarte²,

Marra

et al. 2022

Front. Surg.

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Several materials and techniques have been described for the procedure of chest wall reconstruction: the choice of using a technique or a material over another relies mainly on the surgeon's experience as well as thoracic defect localization and dimension, local availability of materials, and costs. From a technical point of view, autologous and alloplastic reconstruction are available, and, in both cases, rigid and non-rigid prostheses are found. Each material has its peculiarities, with advantages and disadvantages; thus, it is mandatory to be confident when planning the intervention to foresee possible complications and minimize them. We have reviewed the literature on chest wall reconstruction in chest wall tumors (both malignant and non malignant) with non-rigid prosthetic materials, focusing on safety outcomes.

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Section: Discussionmentioning

confidence: 95%

Chest wall reconstruction in benign and malignant tumors with non-rigid materials: An overview

Colella¹,

Brandimarte²,

Marra

et al. 2022

Front. Surg.

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“…They discovered positive outcomes, and none of the patients experienced postoperative complications or soft tissue defects (29). They demonstrated the safety of ADM and its substitutability in chest wall repair after tumor removal (Supplementary Table S1) (29). Also, Giordano et al (93), in a study, compared the postoperative complications of mesh vs. ADM in chest wall reconstruction.…”

Section: Chestmentioning

confidence: 99%

“…Chest wall defects are frequently caused by tumor herniation and resection (1,2,21,29,30,(81)(82)(83)(84)(85)(86)(87)(88)(89)(90)(91). Defects in the chest wall impair the strong framework that supports breathing and safeguards the viscera (92).…”

Section: Chestmentioning

confidence: 99%

“…Consequently, it is essential to repair the chest wall properly (50). The material typically employed in chest wall repair is synthetic mesh (1,2,21,29,30,(81)(82)(83)(84)(85)(86)(87)(88)(89)(90)(91). It does, however, have drawbacks (for example, infection) (93).…”

Section: Chestmentioning

confidence: 99%

“…It does, however, have drawbacks (for example, infection) (93). ADM has so been the subject of investigations to replace the mesh in these operations (Figure 1D) (1,2,21,29,30,33,36,68,(81)(82)(83)(84)(85)(86)(87)(88)(89)(90)(91)(94)(95)(96)(97)(98)(99)(100)(101).…”

Section: Chestmentioning

confidence: 99%

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Acellular dermal matrix in reconstructive surgery: Applications, benefits, and cost

Mohammadyari

Parvin²,

Khorvash³

et al. 2023

Front. Transplant.

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Modern tissue engineering has made substantial advancements that have revolutionized plastic surgery. Acellular dermal matrix (ADM) is an example that has gained considerable attention recently. ADM can be made from humans, bovines, or porcine tissues. ADM acts as a scaffold that incorporates into the recipient tissue. It is gradually infiltrated by fibroblasts and vascularized. Fortunately, many techniques have been used to remove cellular and antigenic components from ADM to minimize immune system rejection. ADM is made of collagen, fibronectin, elastin, laminin, glycosaminoglycans, and hyaluronic acid. It is used in critical wounds (e.g., diabetic wounds) to protect soft tissue and accelerate wound healing. It is also used in implant-based breast reconstruction surgery to improve aesthetic outcomes and reduce capsule contracture risk. ADM has also gained attention in abdominal and chest wall defects. Some studies have shown that ADM is associated with less erosion and infection in abdominal hernias than synthetic meshes. However, its higher cost prevents it from being commonly used in hernia repair. Also, using ADM in tendon repair (e.g., Achilles tendon) has been associated with increased stability and reduced rejection rate. Despite its advantages, ADM might result in complications such as hematoma, seroma, necrosis, and infection. Moreover, ADM is expensive, making it an unsuitable option for many patients. Finally, the literature on ADM is insufficient, and more research on the results of ADM usage in surgeries is needed. This article aims to review the literature regarding the application, Benefits, and costs of ADM in reconstructive surgery.

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Anterolateral Thigh Chimeric Flap: An Alternative Reconstructive Option to Free Flaps for Large Soft Tissue Defects

Lee,

Kim,

Lee

et al. 2023

JCM

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The anterolateral thigh (ALT) skin flap provides abundant, thin, pliable skin coverage with adequate pedicle length and calibre, and tolerable donor site morbidity. However, coverage of relatively large defects using the ALT flap alone is limited. We present our experience of using the ALT flap coupled with the vastus lateralis (VL) flap supplied by the same pedicle for large defect reconstruction. Between 2016 and 2020, ten patients with extensive lower-extremity or trunk defects were treated using the ALT/VL chimeric flap. The ALT portion was used to cover the cutaneous and joint defect while the VL part was used to resurface remnant defects, and a skin graft was performed. All flaps were based on the common descending pedicle, and branches to separate the components were individually dissected. All defects were successfully reconstructed using the ALT/VL chimeric flap. No surgery-related acute complications were observed, and the patients had no clinical issues with ambulation or running activities during the long-term follow-up period. With the separate components supplied by a common vascular pedicle, the ALT/VL chimeric flap allows us to reconstruct extensive defects with joint involvement or posterior trunk lesions. Thus, the ALT/VL chimeric flap may be a suitable alternative for extensive tissue defect reconstruction.

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Acellular dermal matrix and bone cement sandwich technique for chest wall reconstruction

Cited by 4 publications

References 10 publications

Chest wall reconstruction in benign and malignant tumors with non-rigid materials: An overview

Chest wall reconstruction in benign and malignant tumors with non-rigid materials: An overview

Acellular dermal matrix in reconstructive surgery: Applications, benefits, and cost

Anterolateral Thigh Chimeric Flap: An Alternative Reconstructive Option to Free Flaps for Large Soft Tissue Defects

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