Replacement of an extensive chest wall defect in combination with the elimination of postoperative ventral hernia after combined treatment of breast cancer complicated by osteomyelitis of the sternum and ribs

Abstract

Plastic replacement of osteochondral defect of the chest wall after surgical treatment of osteomyelitis of the sternum and ribs is a complex and topical issue in surgery. Often, an extensive post-resected defect of the sternum and ribs is combined with instability of the frame of the chest wall and thoracoabdominal hernia, which leads to physiological and socio-psychological maladaptation of the patient. The case of successful replacement of an extensive chest wall defect in combination with a ventral hernia in a patient after combined treatment of breast cancer complicated by osteomyelitis of the sternum and ribs is presented. TiNi- reinforcing rib prostheses and TiNi-mesh were used to create the frame of the chest wall and hernioplasty. 5-year follow-up did not reveal a recurrence of osteomyelitis and ventral hernia, implant displacement and instability of the frame of the chest wall. The method of reconstruction of an extensive thoracoabdominal defect using bioadaptive implants from TiNi is safe and effective in patients at the final stage of surgical treatment of osteomyelitis of the chest wall including in combination with ventral hernia. Thanks to the developed technology, an excellent functional result was achieved.

Keywords

• osteomyelitis of the sternum and ribs
• chest wall reconstruction
• replacement of post-resected defects
• rib prosthesis
• titanium nickelide implant