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Chest Wall Reconstruction Workup

  • Author: David Jansen, MD, FACS; Chief Editor: Jorge I de la Torre, MD, FACS  more...
 
Updated: Feb 22, 2016
 

Laboratory Studies

Obtain routine preoperative studies.

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Imaging Studies

Obtain baseline chest radiographs. Consider performing a CT scan.

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Other Tests

To successfully perform chest wall reconstruction, a good understanding of the mechanics of breathing and the baseline preoperative pulmonary status are necessary.

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Contributor Information and Disclosures
Author

David Jansen, MD, FACS Chief and Program Director, Section of Plastic and Reconstructive Surgery, Tulane University School of Medicine; Consulting Staff, Surgical Associates LLC

David Jansen, MD, FACS is a member of the following medical societies: American Cleft Palate-Craniofacial Association, Texas Medical Association, American College of Surgeons, American Society of Plastic Surgeons, American Society for Reconstructive Microsurgery, Association for Academic Surgery, Louisiana State Medical Society

Disclosure: Nothing to disclose.

Coauthor(s)

Ernest S Chiu, MD Associate Professor of Surgery, Director of Plastic Surgery Research, Division of Plastic and Reconstructive Surgery, Tulane Health Sciences Center; Co-director of Vascular Anomalies Center, Children's Hospital of New Orleans

Ernest S Chiu, MD is a member of the following medical societies: American Society of Plastic Surgeons, Plastic Surgery Research Council, American Council of Academic Plastic Surgeons

Disclosure: Nothing to disclose.

Azul S Jaffer, MD Fellow in Plastic Surgery, Tulane University School of Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Jaime R Garza, MD, DDS, FACS Consulting Staff, Private Practice

Jaime R Garza, MD, DDS, FACS is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Society for Aesthetic Plastic Surgery, American Society of Maxillofacial Surgeons, Texas Medical Association, Texas Society of Plastic Surgeons

Disclosure: Received none from Allergan for speaking and teaching; Received none from LifeCell for consulting; Received grant/research funds from GID, Inc. for other.

Chief Editor

Jorge I de la Torre, MD, FACS Professor of Surgery and Physical Medicine and Rehabilitation, Chief, Division of Plastic Surgery, Residency Program Director, University of Alabama at Birmingham School of Medicine; Director, Center for Advanced Surgical Aesthetics

Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, American Society for Reconstructive Microsurgery, Association for Academic Surgery, Medical Association of the State of Alabama

Disclosure: Nothing to disclose.

Additional Contributors

Dennis P Orgill, MD, PhD Professor of Surgery, Harvard Medical School; Associate Chief of Plastic Surgery, Brigham and Women's Hospital

Dennis P Orgill, MD, PhD is a member of the following medical societies: American Society for Reconstructive Microsurgery, Plastic Surgery Research Council, American Medical Association, Massachusetts Medical Society

Disclosure: Received consulting fee from Integra LifeSciences, Inc for consulting; Received consulting fee from Integra LifeSciences, Inc. for program and training services agreement; Received grant/research funds from Integra LifeSciences, Inc. for clinical research; Received grant/research funds from KCI for basic science research; Received grant/research funds from KCI for clinical research; Received consulting fee from DSM for consulting; Received consulting fee from Musculoskeletal Transplant Foundatio.

Acknowledgements

R Edward Newsome, MD† Former Program Director and Chief of Plastic Surgery, Henderson Chair in Surgery, Former Assistant Dean for Graduate Medical Education, Tulane University School of Medicine

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Right lateral photo of a patient who underwent pneumonectomy, which was complicated by a bronchopleural cutaneous fistula. The photograph is of the fistula tract.
CT scan showing large right-sided empyema.
Fistulogram.
Omental flap for obliteration of the empyema cavity.
Postoperative photo, chest wall reconstruction.
Infected and open sternal wound after coronary artery bypass graft.
Sternal wound debridement with vacuum-assisted closure therapy.
Sternal wound with omental flap.
Healed sternal wound appearance after omental flap and split-thickness skin graft.
 
 
 
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