Barbara Del Frari1, Anton H Schwabegger. 1. Innsbruck, Austria From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Innsbruck Medical University.
Abstract
BACKGROUND: Various methods of corrective thoracoplasty for congenital anterior chest wall deformities have been described. To date, no studies have described the use of diced cartilage as a surgical procedure in thoracoplasty. The authors present their experience with 23 patients for whom diced cartilage grafts were used as an innovative approach for thoracoplasty. METHODS: A retrospective review of 23 patients was performed. From January of 2004 to September of 2010, 18 patients underwent repair of pectus excavatum, three patients underwent repair of pectus arcuatum, and two patients underwent repair of pectus carinatum using diced rib cartilage grafts. Intraoperative and postoperative complications, patient satisfaction, and clinical outcome were evaluated. Preoperative and postoperative photographs were examined, and the results were assessed by independent surgeons. RESULTS: The mean patient follow-up was 18.1 months. No major complications were observed in the perioperative period. Postoperative complications were mild recurrence of deformity (n = 2). No graft extrusion, infection, or contour irregularities occurred. The patients rated their cosmetic results as very good. All 25 of the wrapped diced cartilage grafts appear to have survived completely, with only one partial graft absorption. One patient had palpable diced cartilage. CONCLUSIONS: The diced cartilage graft technique is a novel and safe procedure in thoracoplastic refinement procedures with clear advantages, including limited surgical trauma, autogenous material, easy preparation, absence of significant donor-site morbidity, absence of additional costs, high patient satisfaction, and good aesthetic results. The authors advocate using this technique for augmentation and contouring of minor anterior wall deformities in selected patients. CLINICAL QUESTION/LEVEL OF EVIDENCE: : Therapeutic, IV.(Figure is included in full-text article.).
BACKGROUND: Various methods of corrective thoracoplasty for congenital anterior chest wall deformities have been described. To date, no studies have described the use of diced cartilage as a surgical procedure in thoracoplasty. The authors present their experience with 23 patients for whom diced cartilage grafts were used as an innovative approach for thoracoplasty. METHODS: A retrospective review of 23 patients was performed. From January of 2004 to September of 2010, 18 patients underwent repair of pectus excavatum, three patients underwent repair of pectus arcuatum, and two patients underwent repair of pectus carinatum using diced rib cartilage grafts. Intraoperative and postoperative complications, patient satisfaction, and clinical outcome were evaluated. Preoperative and postoperative photographs were examined, and the results were assessed by independent surgeons. RESULTS: The mean patient follow-up was 18.1 months. No major complications were observed in the perioperative period. Postoperative complications were mild recurrence of deformity (n = 2). No graft extrusion, infection, or contour irregularities occurred. The patients rated their cosmetic results as very good. All 25 of the wrapped diced cartilage grafts appear to have survived completely, with only one partial graft absorption. One patient had palpable diced cartilage. CONCLUSIONS: The diced cartilage graft technique is a novel and safe procedure in thoracoplastic refinement procedures with clear advantages, including limited surgical trauma, autogenous material, easy preparation, absence of significant donor-site morbidity, absence of additional costs, high patient satisfaction, and good aesthetic results. The authors advocate using this technique for augmentation and contouring of minor anterior wall deformities in selected patients. CLINICAL QUESTION/LEVEL OF EVIDENCE: : Therapeutic, IV.(Figure is included in full-text article.).