Huang SC, Chen CY, Qiu P, Yan ZM, Chen WZ, Liang ZZ, Luo KW, Li JW, Zhang YQ, Huang BY. Reconstruction of complex chest wall defects: A case report. World J Clin Cases 2022; 10(11): 3505-3510 [PMID: 35582050 DOI: 10.12998/wjcc.v10.i11.3505]
Corresponding Author of This Article
Yuan-Qi Zhang, PhD, Dean, Department of Vascular, Thyroid, and Breast Surgery, Affiliated Hospital of Guangdong Medical University, No. 57 Renmin Avenue South, Xiashan District, Zhanjiang 524000, Guangdong Province, China. 31428319@qq.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Sheng-Chao Huang, Chun-Yan Chen, Pu Qiu, Ze-Ming Yan, Wei-Zhang Chen, Zhong-Zheng Liang, Kang-Wei Luo, Jian-Wen Li, Yuan-Qi Zhang, Bao-Yi Huang, Department of Vascular, Thyroid, and Breast Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524000, Guangdong Province, China
Author contributions: Zhang YQ contributed to conception and design of the case report; Li JW contributed administrative support; Huang SC and Qiu P contributed to provision of study materials or patients; Liang ZZ, Yan ZM and Luo KW contributed to collection and assembly of data; Huang BY, Chen CY and Chen WZ contributed to data analysis and interpretation; Qiu P, Chen CY, Huang SC, Yan ZM, Chen WZ, Liang ZZ, Luo KW, Huang BY, Li JW and Zhang YQ contributed to manuscript writing and final approval of the manuscript.
Informed consent statement: The patient’s consent was obtained for the anonymized release of the case data.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuan-Qi Zhang, PhD, Dean, Department of Vascular, Thyroid, and Breast Surgery, Affiliated Hospital of Guangdong Medical University, No. 57 Renmin Avenue South, Xiashan District, Zhanjiang 524000, Guangdong Province, China. 31428319@qq.com
Received: December 15, 2021 Peer-review started: December 15, 2021 First decision: January 26, 2022 Revised: February 3, 2022 Accepted: February 27, 2022 Article in press: February 27, 2022 Published online: April 16, 2022 Processing time: 114 Days and 3.2 Hours
Abstract
BACKGROUND
Chronic radiative chest wall ulcers are common in patients undergoing radiation therapy. If not treated early, then symptoms such as erosion, bleeding and infection will appear on the skin. In severe cases, ulcers invade the ribs and pleura, presenting a mortality risk. Small ulcers can be repaired with pedicle flaps. Because radioactive ulcers often invade the thorax, surgeons need to remove large areas of skin and muscle, and sometimes ribs. Repairing large chest wall defects are a challenge for surgeons.
CASE SUMMARY
A 74-year-old female patient was admitted to our department with chest wall skin ulceration after radiation therapy for left breast cancer. The patient was diagnosed with chronic radioactive ulceration. After multidisciplinary discussion, the authors performed expansive resection of the chest wall ulcers and repaired large chest wall defects using a deep inferior epigastric perforator (DIEP) flap combined with a high-density polyethylene (HDPE) patch. The patient was followed-up 6 mo after the operation. No pigmentation or edema was found in the flap.
CONCLUSION
DIEP flap plus HDPE patch is one of the better treatments for radiation-induced chest wall ulcers.
Core Tip: In recent years, with the development of microsurgical techniques and breast reconstruction techniques and the wide application of autologous flap transplantation, breast surgeons have provided new ideas for the treatment of chronic radiation-induced ulcers of the chest wall. Deep inferior epigastric perforator flap combined with a high-density polyethylene patch is a promising treatment for chronic radiation-induced ulcers of the chest wall.
