Radionecrosis of the chest wall requires wide resection of irradiated and infected tissue. Covering the wound with the omentum is a safe and reliable procedure, but, if the pleura has been opened the omentum will not provide airtightness. This video describes a simple trick to overcome this difficulty, allowing the use of the omentum in all cases.
Dear Dr. Bellami,
Did you consider using the breast for closure?
Thanks for your video of a very interesting case and resolution.
Luis M. Argote-Greene MD
Thoracic Surgery
Dear Dr Bellami,
Thank you for sharing this interesting case. The omentum is indeed the preferred flap for primary closure of such an extensive chest wall defect. However, (meshed) skin grafting is possible, directly onto the omentum, with autologous fibrin glue (Eur J Cardiothorac Surg. 2010;37:87-92) at the time of the primary reconstruction OR the omentum containing wound could have been primarilycovered with a flap developed from the contralateral, very ptotic breast (instead of waiting for 4 weeks). Jan J van Wingerden, MBChB, MMed, FCS(SA)