Muscle sparing latissimus dorsi flap for reconstruction of a large chemo-necrosis of the chest wall: A case report.

Chemonecrosis Chimio-nécrose Extravasation de chimiothérapie Extravasation of chemotherapy Lambeau de grand dorsal avec préservation musculaire Muscle sparing latissimus dorsi flap

Journal

Annales de chirurgie plastique et esthetique
ISSN: 1768-319X
Titre abrégé: Ann Chir Plast Esthet
Pays: France
ID NLM: 8305839

Informations de publication

Date de publication:
Mar 2022
Historique:
received: 22 11 2021
accepted: 03 01 2022
pubmed: 27 1 2022
medline: 31 5 2022
entrez: 26 1 2022
Statut: ppublish

Résumé

Extravasation of chemotherapeutic agents is a common complication in cancer centers. In severe cases involving large tissue necrosis, surgery may be needed to resect necrotic tissues and to cover the exposed areas. A 71 years old women was referred to our unit two month after extravasation of epirubicin from an implanted port-a-cath with a large chemonecrosis of the anterior chest wall. She presented an evolutive tissue necrosis extending from the upper anterior thoracic region to the right breast. Surgical debridements and negative wound pressure therapy were necessary in order to obtain clean areas. The final chest wall defect was covered using a Muscle Sparing Latissimus Dorsi pedicled flap. This surgical management have permitted a satisfying wound healing and functional recovery without any complication. Chemotherapeutics' extravasations can be a severe complication of oncologic treatment and have to be discussed between oncologists and plastic surgeons to find the most effective and suitable solution with consideration of the specificities of cancer therapy. In chest wall skin defect, the use of muscle sparing latissimus dorsi pedicled flap is a robust solution with low morbidity of the donor site.

Sections du résumé

BACKGROUND BACKGROUND
Extravasation of chemotherapeutic agents is a common complication in cancer centers. In severe cases involving large tissue necrosis, surgery may be needed to resect necrotic tissues and to cover the exposed areas.
CLINICAL CASE DESCRIPTION UNASSIGNED
A 71 years old women was referred to our unit two month after extravasation of epirubicin from an implanted port-a-cath with a large chemonecrosis of the anterior chest wall. She presented an evolutive tissue necrosis extending from the upper anterior thoracic region to the right breast. Surgical debridements and negative wound pressure therapy were necessary in order to obtain clean areas. The final chest wall defect was covered using a Muscle Sparing Latissimus Dorsi pedicled flap. This surgical management have permitted a satisfying wound healing and functional recovery without any complication.
CONCLUSION CONCLUSIONS
Chemotherapeutics' extravasations can be a severe complication of oncologic treatment and have to be discussed between oncologists and plastic surgeons to find the most effective and suitable solution with consideration of the specificities of cancer therapy. In chest wall skin defect, the use of muscle sparing latissimus dorsi pedicled flap is a robust solution with low morbidity of the donor site.

Identifiants

pubmed: 35078673
pii: S0294-1260(22)00001-2
doi: 10.1016/j.anplas.2022.01.001
pii:
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

105-110

Informations de copyright

Copyright © 2022 Elsevier Masson SAS. All rights reserved.

Auteurs

J Fraisse (J)

Department of Onco-Plastic Surgery, IUCT-Oncopole University Hospital, 1, avenue Irène Joliot-Curie, 31100 Toulouse, France; Department of Plastic Reconstructive Surgery and Burns, Rangueil University Hospital, Toulouse, France. Electronic address: juliette.fraisse@gmail.com.

D Gangloff (D)

Department of Onco-Plastic Surgery, IUCT-Oncopole University Hospital, 1, avenue Irène Joliot-Curie, 31100 Toulouse, France; Department of Plastic Reconstructive Surgery and Burns, Rangueil University Hospital, Toulouse, France.

T Meresse (T)

Department of Onco-Plastic Surgery, IUCT-Oncopole University Hospital, 1, avenue Irène Joliot-Curie, 31100 Toulouse, France; Department of Plastic Reconstructive Surgery and Burns, Rangueil University Hospital, Toulouse, France.

C Berthier (C)

Department of Onco-Plastic Surgery, IUCT-Oncopole University Hospital, 1, avenue Irène Joliot-Curie, 31100 Toulouse, France.

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Classifications MeSH