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Subscapularis muscle flap for reconstruction of posterior chest wall skeletal defect.

Sakai M, Yamaoka M, Goto Y, Sato Y - Int J Surg Case Rep (2015)

Bottom Line: The resulting chest wall defect was covered with a polytetrafluoroethylene mesh that became infected postoperatively.The lower third of the scapula was excised since blood supply to the scapula tip may be reduced after dissection of the subscapularis muscle, and to prevent the scapula tip from falling into the thoracic cavity.The use of a subscapularis muscle flap to repair chest wall defect is a simple and safe technique that can be conducted in the same surgical field as the initial reconstruction surgery and does not require plastic surgery support.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic Surgery, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki 305-8558, Japan; Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan. Electronic address: mitsdoc41@gmail.com.

No MeSH data available.


Related in: MedlinePlus

A: Computed tomography image after the initial lobectomy, with chest wall resection, showing that the scapula tip had fallen into the thoracic cavity. B: Excised scapula prevents it from falling into the thoracic cavity.
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fig0010: A: Computed tomography image after the initial lobectomy, with chest wall resection, showing that the scapula tip had fallen into the thoracic cavity. B: Excised scapula prevents it from falling into the thoracic cavity.

Mentions: In our experience, it is important to suture the subscapularis muscle flap to the serratus anterior and rhomboid major muscles for thoracic cavity closure and to ensure adequate blood supply to the free end of the flap. The subscapularis muscle and scapula are supplied by the dorsal scapular artery, suprascapular artery, and subscapular artery, which form an arterial plexus around the scapula [4]. A previous study identified the angular branch of the thoracodorsal artery to be the main vascular supply to the scapula tip [4]. In the present case, the lower third of the scapula was excised since blood supply to the scapula tip may be reduced after dissection of the subscapularis muscle, and to prevent the scapula tip from falling into the thoracic cavity (Fig. 2).


Subscapularis muscle flap for reconstruction of posterior chest wall skeletal defect.

Sakai M, Yamaoka M, Goto Y, Sato Y - Int J Surg Case Rep (2015)

A: Computed tomography image after the initial lobectomy, with chest wall resection, showing that the scapula tip had fallen into the thoracic cavity. B: Excised scapula prevents it from falling into the thoracic cavity.
© Copyright Policy - CC BY-NC-SA
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4430181&req=5

fig0010: A: Computed tomography image after the initial lobectomy, with chest wall resection, showing that the scapula tip had fallen into the thoracic cavity. B: Excised scapula prevents it from falling into the thoracic cavity.
Mentions: In our experience, it is important to suture the subscapularis muscle flap to the serratus anterior and rhomboid major muscles for thoracic cavity closure and to ensure adequate blood supply to the free end of the flap. The subscapularis muscle and scapula are supplied by the dorsal scapular artery, suprascapular artery, and subscapular artery, which form an arterial plexus around the scapula [4]. A previous study identified the angular branch of the thoracodorsal artery to be the main vascular supply to the scapula tip [4]. In the present case, the lower third of the scapula was excised since blood supply to the scapula tip may be reduced after dissection of the subscapularis muscle, and to prevent the scapula tip from falling into the thoracic cavity (Fig. 2).

Bottom Line: The resulting chest wall defect was covered with a polytetrafluoroethylene mesh that became infected postoperatively.The lower third of the scapula was excised since blood supply to the scapula tip may be reduced after dissection of the subscapularis muscle, and to prevent the scapula tip from falling into the thoracic cavity.The use of a subscapularis muscle flap to repair chest wall defect is a simple and safe technique that can be conducted in the same surgical field as the initial reconstruction surgery and does not require plastic surgery support.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic Surgery, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki 305-8558, Japan; Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan. Electronic address: mitsdoc41@gmail.com.

No MeSH data available.


Related in: MedlinePlus