RISKS AND BENEFITS OF USING MARLEX MESH IN CHEST-WALL RECONSTRUCTION

The records of 101 patients who had undergone chest wall reconstructio n both with and without stabilization of the chest wall by Marlex mesh were reviewed to see if Marlex reduced ventilator dependence and hosp ital stay, and to determine whether the use of Marlex was associated w ith any increased risk of infection. In 40 patients in whom Marlex was used, the mean number of days on postoperative ventilator support was 0.8, and mean hospital stay was 9.7 days. In 61 patients in whom Marl ex was not used, the mean number of days on ventilator support was 4.9 , and mean hospital stay was 17.5 days. These differences were statist ically significant (p = 0.03, p = 0.006). Two patients in the Marlex-s tabilized group (5%) developed wound infections, but these were preced ed by ischemic necrosis of overlying flaps. None of the patients witho ut Marlex developed wound infections. That difference was not statisti cally significant. We conclude that the use of Marlex in chest wall re construction does not significantly increase the risk of wound infecti on, provided that overlying tissues are properly vascularized and rema in viable, and that synthetic mesh does improve chest wall stability a nd reduce ventilator dependence and overall hospital stay.