Objectives: To evaluate the effectiveness and early outcome of using prolene mesh with and without methyl-methacrylate for chest wall reconstruction in non-neoplastic lesions
Patients & Methods: The study included 19 patients; three patients had bifid sternum, nine patients had chest trauma in the form of blast injury due to gunshot with lost part of the lateral chest wall (full thickness) and seven patients had chest trauma with flail segment of the lateral chest wall with multiple fragmented ribs. All patients received general anesthesia with endotracheal intubation. Patients with bifid sternum operated in supine position and managed by prolene mesh with methyl-methacrylate. All trauma patients managed in lateral decubitus with the affected side up, prolene mesh used in all patients and methyl-methacrylate used with the prolene mesh in patients with large defect areas.
Results: The study included 19 patients, 14 males and 5 females. The mean age was 39.42 years ranged from one year to 67 years. Methyl-methacrylate (bone cement) sandwiched between two layers of prolene mesh used was in 42.1% of patients, in 57.9% of patients a double layer of prolene mesh used without using methyl-methacrylate. 63.2% of patients had no postoperative complications, 10.5% of patients complicated by prolonged air-leak (> 7 days), 10.5% of patients complicated by seroma and 15.8% of patients complicated by wound infection. There was no intraoperative nor postoperative mortality.
Conclusion: Using a prosthesis of double layered prolene mesh if sutured under tension is an effective method of chest wall reconstruction, if the defect area is large addition of methyl methacrylate increases the hardness of the prosthesis. This method of chest wall reconstruction has few postoperative complications and favourable outcome. |
