Chest Wall Surgical Review

1
Chest Wall Surgical Review

• Lucas Henn

2
Chest Wall Tumors

• Resection of a primary chest wall tumor requires
  at least a 4 cm margin- can leave a big defect
• If attached to the lung- resect the lung lobe too
• If boney in origin- resect the entire rib as well
• Goal is not tissue conservation- it is negative
  margins

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Reconstruction

• Usually anything greater than 5cm
• Firm stabilization of the bony thorax using a 2mm
  PTFE or synthetic mesh
• Can use steel mesh for sternectomy or anterior
  defect
• Defects made in ribs or transverse process of the
  spine and heavy gauge non absorbable sutures used
  through the holes
• Tissue coverage via muscle flaps

4
Chest Tubes

• Osman/Sparks with help from S. Patel will
  describe the perfect placement of a chest tube