Chest wall reconstruction rebuilds the ribs, sternum and overlying soft tissue after tumour removal, trauma, infection following heart surgery, radiation injury or congenital deformities. Surgeons use muscle flaps, mesh or both to restore stability, protect the heart and lungs and close the wound, aiming for good breathing function and appearance.
- AnaesthesiaGeneral
- Hospital stayTypically 4 to 5 days
- Back to routineUsually 4 to 6 weeks for light activity
What is chest wall reconstruction?
Chest wall reconstruction is performed after infections following open-heart surgery, after tumour resection leaves a chest wall defect, and for congenital deformities, cancer or non-healing wounds. It rebuilds bone (ribs, sternum and costal cartilage) and the overlying soft tissue. Surgeons use regional flaps, mesh or both; flaps contain skin and fat, sometimes with muscle.
Postpneumonectomy empyema cavities are treated by finding and closing bronchopleural fistulas and filling the space with muscle flaps such as latissimus dorsi, serratus anterior, pectoralis major, omentum or rectus abdominis. Infected sternums can be reconstructed with pectoralis major flaps, rectus abdominis, external oblique or latissimus dorsi flaps, or omentum.
Partial-thickness soft tissue defects are usually treated with skin grafts. Full-thickness defects need muscle flaps, chosen according to the skin needed, chest wall stability, protection of the chest organs and donor-site considerations.
Who is chest wall reconstruction for?
- People with radiation injury of the chest wall
- Patients with chest wall trauma
- People with chest infections such as empyema, bronchopleural fistula or sternal infection
- Patients needing resection of chest wall, lung or mediastinal tumours
- People with congenital conditions such as pectus excavatum or carinatum and Poland syndrome
How is it done?
- Physical examination and diagnostic tests, including imaging
- Debridement or resection of infected, irradiated or tumour tissue
- Skeletal stabilisation with mesh or other materials where needed
- Cover with muscle flaps such as pectoralis major, latissimus dorsi or rectus abdominis, or omentum
- Skin grafts for partial-thickness defects
What is recovery like?
- Hospital stay is typically 4 to 5 days, depending on your condition
- Pain relief is provided; avoid driving while taking strong painkillers
- Deep diaphragmatic breathing exercises help the lungs
- Avoid strenuous exercise and lifting more than about 10 pounds (4.5 kg) for several weeks
- Avoid heat on the incision
What are the risks?
- Infection
- Flap necrosis or superficial skin loss
- Loss of sensation
- Scarring
- Haematoma or seroma
- Breathing difficulties in larger resections
Why choose Dr. Jithendran?
- Dual training in orthopaedics (MS) and plastic surgery (MCh, DNB), with hand and microsurgery experience from Ganga Hospital, Coimbatore
- Consults at five hospitals across Bengaluru, with 24×7 availability for emergencies
- Clear explanations in English, Tamil, Hindi and Telugu, and time to answer every question
- Strict sterilisation and patient-privacy standards
Frequently asked questions
Why is chest wall reconstruction needed?
The chest wall protects the heart and lungs and supports breathing. When part of it is removed for a tumour, damaged by injury or radiation, or infected after heart surgery, reconstruction restores stability, protects the organs and closes the wound with healthy tissue.
What is used to rebuild the chest wall?
Bony defects may be stabilised with mesh or other materials, and the soft tissue is rebuilt with flaps, usually muscles such as pectoralis major, latissimus dorsi or rectus abdominis, or the omentum. Superficial defects can be covered with skin grafts.
How should I prepare for chest wall reconstruction?
Stop smoking and alcohol, stop blood thinners and aspirin-containing medicines as advised, fast from midnight, take daily medicines with only a sip of water, and wash the surgical area with chlorhexidine scrub after showering on the day of surgery.
How long is recovery after chest wall reconstruction?
Most patients stay in hospital about 4 to 5 days. At home, avoid strenuous exercise, practise deep breathing, avoid lifting more than about 10 pounds, and do not drive while taking strong pain medicines. Recovery to normal activity typically takes several weeks.
