N. Bogossian et al., EXTERNAL OBLIQUE MYOCUTANEOUS FLAP COVERAGE OF LARGE CHEST-WALL DEFECTS FOLLOWING RESECTION OF BREAST-TUMORS, Plastic and reconstructive surgery, 97(1), 1996, pp. 97-103
Defects resulting from resection of advanced breast tumors can be quit
e large, posing a difficult reconstructive challenge. A significant nu
mber of such patients present with local recurrences after receiving e
xternal beam radiation and/or chemotherapy treatments. Pectoralis majo
r, latissimus dorsi, rectus abdominis, and omental flaps with split-th
ickness skin grafts have been recommended for closure of chest-wall de
fects. What is often excluded from the list of reconstructive options
is the external oblique myocutaneous flap. In our series of 20 consecu
tive patients treated at Memorial Sloan-Kettering Cancer Center, an ex
ternal oblique myocutaneous flap was used to cover these large chest-w
all defects successfully. The median age of our patient population was
54.5 years, and 68 percent of them presented with local recurrence. F
ifty percent had external beam radiation, and fifty percent had receiv
ed chemotherapy. Twenty-five percent of our study group had had both t
reatments. The mean chest-wall defect measured 326 cm(2), correspondin
g to a 20 X 16 cm area. We believe that the external oblique myocutane
ous flap should be considered a safe and reliable option when reconstr
uction of large chest-wall defects is contemplated.