EXTERNAL OBLIQUE MYOCUTANEOUS FLAP COVERAGE OF LARGE CHEST-WALL DEFECTS FOLLOWING RESECTION OF BREAST-TUMORS

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.