The extended pectoralis major flap for reconstruction of the upper posterior chest wall and axilla Niklas Iblher, MD, Vincenzo Penna, MD, Arash Momeni,

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Presentation transcript:

The extended pectoralis major flap for reconstruction of the upper posterior chest wall and axilla Niklas Iblher, MD, Vincenzo Penna, MD, Arash Momeni, MD, Nestor Torio Padron, MD, G. Bjoern Stark, MD, Prof The Journal of Thoracic and Cardiovascular Surgery Volume 136, Issue 3, Pages 790-791.e13 (September 2008) DOI: 10.1016/j.jtcvs.2007.11.066 Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Defect and flap design. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 790-791.e13DOI: (10.1016/j.jtcvs.2007.11.066) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Flap transposition. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 790-791.e13DOI: (10.1016/j.jtcvs.2007.11.066) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Wound closure. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 790-791.e13DOI: (10.1016/j.jtcvs.2007.11.066) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Patient 1: Preoperative situation with R2 resection of a malignant melanoma. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 790-791.e13DOI: (10.1016/j.jtcvs.2007.11.066) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Patient 1: Design of extended musculocutaneous pectoralis major flap. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 790-791.e13DOI: (10.1016/j.jtcvs.2007.11.066) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Patient 1: Intraoperative situation Patient 1: Intraoperative situation. Above wide resection including the margo lateralis, spina, and pars membranacea of the scapula and the periscapular and parascapular muscles. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 790-791.e13DOI: (10.1016/j.jtcvs.2007.11.066) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Patient 1: Six months postoperatively showing almost normal shoulder function. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 790-791.e13DOI: (10.1016/j.jtcvs.2007.11.066) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Patient 2: Situation after incisional biopsy revealing a liposarcoma. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 790-791.e13DOI: (10.1016/j.jtcvs.2007.11.066) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Patient 2: Defect after wide resection including the lower trapezius, latissimus, teres major and minor, and the periostium of the lower scapula. Insertion of the serratus muscle was free of tumor and was left intact. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 790-791.e13DOI: (10.1016/j.jtcvs.2007.11.066) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Patient 2: Three months postoperatively. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 790-791.e13DOI: (10.1016/j.jtcvs.2007.11.066) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Patient 3: Defect after wide resection of a pleomorphic sarcoma. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 790-791.e13DOI: (10.1016/j.jtcvs.2007.11.066) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Patient 3: Flap design of extended pectoralis major myocutaneous flap. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 790-791.e13DOI: (10.1016/j.jtcvs.2007.11.066) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Patient 3: Flap transposition. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 790-791.e13DOI: (10.1016/j.jtcvs.2007.11.066) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Patient 3: Wound closure. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 790-791.e13DOI: (10.1016/j.jtcvs.2007.11.066) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Patient 3: Result after 18 months. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 790-791.e13DOI: (10.1016/j.jtcvs.2007.11.066) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions