Anterior chest wall reconstruc tion with heterologous acellular dermal matrix- clinical case report

Abstract

Anterior chest wall reconstruction is a challenging initiative, particularly after deep sternal infection. The location and the size of the defect play a major role when selecting the method of repair, while good aesthetic and functional outcome remain a primary goal. Aloplastic materials are often used for sternal stabilization and loco-regional fl aps are applied to provide well vascularized soft tissue coverage. Although numerous products are available today, acellular dermal matrices have some advantage that could be of benefi t in the repair of the anterior mediastinum and chest wall. In this clinical report, we present a case of a patient whit poststernotomy mediastinitis and wound dehiscence after cardiovascular surgery and failure of the initial chest wall repair. After conservative treatment and Negative Pressure Wound Therapy, titanium plates were used to restore the sternal continuity. Acellular dermal matrix of porcine origin was applied for improving and reinforcing the fi xation plates and soft tissue repair accomplished by local muscle fl aps. Due to its ability to become incorporated and vascularized, to resist wound infections and to provide stability, acellular dermal matrix seems to be a promising although probably not enough effi cient alternative of the synthetic materials in sternal reconstruction and anterior chest wall repair.