Plastic Surgery Essentials for Students-Chapter 13: Trunk Reconstruction

Chapter 13: Trunk Reconstruction

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Chapter 13 of the referenced medical text focuses on trunk reconstruction, with emphasis on abdominal and chest wall anatomy, pathologies, and reconstructive strategies. The abdominal wall is composed of layers including skin, subcutaneous tissue, Scarpa's fascia, and various muscle groups. Key goals in abdominal wall reconstruction are protecting intra-abdominal organs, preventing hernias, and maintaining abdominal wall function. Common conditions necessitating reconstruction include tumor resections, infections, trauma, and congenital anomalies. For reconstruction, methods range from primary closure to the use of prosthetic and biological materials, and more complex techniques such as component separation and tissue expansion.<br /><br />The chest wall section details the skin, subcutaneous tissue, bony structures, and musculature like the pectoralis and intercostal muscles. Reconstruction goals here also include creating a rigid, airtight chest cavity and optimizing respiration, especially after trauma, tumor resection, or infection. Various reconstructive measures include primary closure, wound vacs to assist healing and breathing mechanics, and use of alloplastic or autologous materials to fill defects. Autologous reconstruction often uses loco-regional pedicled flaps, like the pectoralis major or latissimus dorsi.<br /><br />Congenital chest wall deformities such as Poland's Syndrome and pectus excavatum are addressed with tissue expanders, surgical repositioning, and support structures. Treatment of pectus carinatum generally involves repositioning the sternum and abnormal cartilages.<br /><br />Throughout, the text underscores the importance of understanding detailed anatomy for effective surgical intervention and emphasizes considerations for reducing complications, especially in the presence of prosthetic materials.

Keywords

trunk reconstruction

abdominal wall

chest wall

reconstructive strategies

prosthetic materials

component separation

tissue expansion

autologous reconstruction

congenital deformities

surgical intervention