THE PEDICLED OMENTOPLASTY AND SPLIT SKIN-GRAFT (POSSG) FOR RECONSTRUCTION OF LARGE CHEST-WALL DEFECTS - A VALIDITY STUDY OF 34 PATIENTS

The aim of this study was to evaluate retrospectively the results of p edicled omentoplasty and split skin graft (POSSG) in reconstructing (f ull thickness) chest wall defects, and to define its role as a palliat ive procedure for local symptom control, Thirty-four patients with rec urrent breast cancer (n = 25), radiation-induced necrosis (n = 5) or s arcoma (rt = 4) of the chest wall were selected for the study, All pat ients underwent curative or palliative chest wall resection with recon struction by pedicled omentoplasty and split skin graft (POSSG), betwe en 1986 and 1994, Reconstructive outcome, complications, local tumour and symptom control following surgery was measured, The most common co mplication was shown to be partial necrosis of the omental flap (35%), followed by respiratory problems (26%), facial hernia (26%) and thora cic wound problems (15%), which were mostly treated in a conservative way (68%), The 3-year local tumour-free interval after POSSG in patien ts curatively treated for breast cancer is 16%, Seventy per cent of th e patients who underwent palliative resection had longstanding relief of local pain, bleeding or foetor due to local tumour growth, It can b e concluded that large (full thickness) chest wall defects after resec tion of local recurrence, primary malignancy or osteoradionecrosis of the chest wall can successfully be reconstructed by POSSG, Chest wag r esection in patients treated with palliative intention is effective in local symptom control.