Chest Wall Reconstruction: A Comprehensive Analysis

Purpose of Review Chest wall reconstruction often includes complex defects requiring coordination with consulting services and attention to both skeletal and soft tissue defects. Through a review of the historical context of chest wall reconstruction, this article will address current considerations for both components of reconstruction. Special considerations related to reconstruction of the chest wall will be reviewed. Recent Findings Exciting advancements have been made in the past decade in solving the ongoing challenge to find optimal materials for use in skeletal reconstruction and stabilization. Biologic meshes and titanium osteosynthesis devices may provide future promise in chest wall reconstruction and continue to be evaluated. Additionally, 3D printing presents an opportunity to custom design implants for skeletal defects. Though principles of soft tissue reconstruction remain pillars to successful chest wall reconstruction, advances in the management of tumors, as well as care of complex cardiac and pulmonary surgical patients, have allowed an opportunity to address more complex intrathoracic and extrathoracic defects. Summary Reconstruction of chest wall defects presents unique challenges to the reconstructive surgeon. Consideration of patient factors, as well as reconstructive components, should be discussed preoperatively. Although complication rates remain high in this population, involvement of the plastic reconstructive surgeon and use of flap reconstruction have been shown to reduce morbidity and mortality in chest wall reconstruction.