Combined latissimus dorsi myocutaneous flap and 3D-printed PEEK implant for reconstruction of a large full-thickness chest wall defect: A retrospective study.

Abstract

Reconstruction of extensive full-thickness chest wall defects is a noticed challenge within the field. Although 3D-printed polyether ether ketone (PEEK) has exhibited promising outcomes in cranial and maxillary reconstruction, its application combined with flap in reconstruction of a full-thickness chest wall defects remains unexplored. Over the span from November 2018 to March 2024, a retrospective study involving 12 patients who underwent chest wall reconstruction using latissimus dorsi myocutaneous flap (LDMF) combined with 3D-printed PEEK prostheses after tumor resections at our institution was meticulously conducted. Comprehensive clinical data, encompassing patient demographics, tumor characteristics, surgical details, postoperative complications, and long-term functional outcomes, were methodically collected, analyzed, and synthesized. Among the cohort of 12 patients, 11 experienced successful primary wound healing, whereas a single case necessitated secondary intervention involving debridement and suturing because of necrosis at the distal end of the flap. The follow-up duration ranged from 3 to 54 months. The PEEK prosthesis demonstrated excellent stability, structural support, and integration with surrounding tissues. All the LDMFs exhibited well-defined contours and compatibility with the implants. Functional assessments including mobility of the repaired thoracic wall, respiratory function, shoulder joint movement, pain, cosmetic appearance, and quality of life yielded consistently satisfactory results. The combined utilization of LDMF with 3D-printed PEEK prostheses offers a tailored and resilient approach for comprehensive full-thickness chest wall reconstruction postextensive tumor resection. This method achieves satisfactory functional outcomes with minimal postoperative complications, contributing to prolonged survival and enhanced quality of life.