Journal CME Article: The Best of Chest Wall Reconstruction: Principles and Clinical Application for Complex Oncologic and Sternal Defects

Keyword(s) Kathryn V. Isaac MD MPH, Kate Elzinga MD, Edward W. Buchel MD, sternal defect, oncologic, respiratory compromise, oncologic resection, skeletal stabilization, chest wall, anatomy

Credits CME:1.0, Patient Safety:0.5

Tag(s) Reconstructive/Microsurgery, CME, PRS Journal Courses, Member Benefit

Description

Chest wall reconstruction restores respiratory function, provides protection for underlying viscera, and supports the shoulder girdle. Common indications for chest wall reconstruction include neoplasms, trauma, infectious processes, and congenital defects. Loss of chest wall integrity can result in respiratory and cardiac compromise and upper extremity instability. Advances in reconstructive techniques have expanded the resectability of large complex oncologic tumors by safely and reliably restoring chest wall integrity in an immediate fashion with minimal or no secondary deficits. The purpose of this article is to provide the reader with current evidenced-based knowledge to optimize care of patients requiring chest wall reconstruction. This article discusses the evaluation and management of oncologic chest wall defects, reviews controversial considerations in chest wall reconstruction, and provides an algorithm for the reconstruction of complex chest wall defects. Respiratory preservation, semirigid stabilization, and longevity are key when reconstructing chest wall defects.

Faculty
Kathryn V. Isaac, M.D.; M.P.H. Kate Elzinga, M.D.; Edward W. Buchel, M.D.

Plastic and Reconstruction Surgery®Editors:
Editor-in-Chief:Kevin Chung, MD
Co-Editor:Amy Colwell, MD
Section Editors:John Y.S. Kim, MD

Intended Audience
This educational activity is intended for all CME-related persons including plastic surgery practitioners, residents, and other healthcare professionals.

Learning Objectives
After viewing this course, the participant should be able to:

Appraise and evaluate risk factors for respiratory compromise following oncologic resection.
Outline and apply an algorithmic approach to reconstruction of the chest wall based on defect composition, size, and characteristics of surrounding tissue.
Recognize and evaluate indications for and types of skeletal stabilization of the chest wall.
Critically consider, compare, and select pedicled and free flaps for chest wall reconstruction that do not impair residual respiratory function or skeletal stability.

Accreditation
The American Society of Plastic Surgeons (ASPS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation
The ASPS designates this enduring material for a maximum of1.0AMA PRA Category 1 Credit. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Recognition Statement

The Continuing Medical Education (CME) credits offered by this activity are enhanced by ASPS Learner Credit Reportingfor learners who have opted into this reporting. Successful completion of this CME activity enables active American Board of Surgery (ABS) members the opportunity to earn credit toward the CME requirement of the ABS's Continuous Certification program when claimed within 30 days of completion of the activity.

Participants in ASPS-accredited education who want their CME credits reported to certifying and state licensing boards must opt-into reporting and add their NPI as well as state license ID and/or collaborating board ID(s) before claiming credit.

Disclosure Policy
The American Society of Plastic Surgeons (ASPS) requires all faculty, authors, planners, reviewers, managers, staff and other individuals in a position to control or influence the content of an activity to disclose all relevant financial relationships or affiliations. All identified conflicts of interest must be resolved and the educational content thoroughly vetted by ASPS for fair balance, scientific objectivity and appropriateness of patient care recommendations. The ASPS also requires faculty/authors to disclose when off-label/unapproved uses of a product are discussed in a CME activity or included in related materials.

Disclaimer: All relevant financial relationships for planners, faculty, and others in control of content (either individually or as a group) are reviewed by the ASPS Continuing Education Committee and have been mitigated, if applicable.

The following planners/faculty members/reviewers have no relevant financial relationships or affiliations to disclose:

Kathryn V. Isaac, M.D.; M.P.H. Kate Elzinga, M.D.; Edward W. Buchel, M.D.

AMA PRA Category 1 Credit^TM: 1.0
Patient Safety Credit: 0.5
Media:Journal Article, video
Release Date: 03/01/2022
Expiration Date: 03/01/2025*
Estimated time to complete this course: 1 hour

*Course access ends on course expiration date

Directly provided by the American Society of Plastic Surgeons (ASPS)

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