CopyrightedMaterial CopyrightedMaterial CopyrightedMaterial Reconstructive Surgery of the Chest, Abdomen, and Pelvis CopyrightedMaterial CopyrightedMaterial Reconstructive Surgery of the Chest, Abdomen, and Pelvis edited by Gregory R. D. Evans UniversityofCalifornia atIrvine Irvine, California, U5.A. MARCEL MARCEL DEKKER, INC. NEW YORK· BASEL CopyrightedMaterial CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2004 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Version Date: 20140807 International Standard Book Number-13: 978-0-8493-7808-9 (eBook - PDF) This book contains information obtained from authentic and highly regarded sources. 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Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com Preface The art ofplastic surgery is the restoration ofform and function. We have become proficient in the transfer of flaps for these functional restorations, but recent tech niques have focused on these restorations with a more aesthetic approach and im provementin thequalityoflife.Itiswiththesenewfounddirectionsthatreconstructive surgery can expand beyond "just coverage of the wounds" and focus more on the aesthetic restoration ofsoft and bony defects. In our search for these more focused operations, reconstructionofthechest,abdomen, and pelvisarecritical for maintain ingambulation, pulmonary function, and a sense ofappearance. This book attempts to expand upon these time-honored and new aesthetic techniques to the trunk. The most common operative procedures likely to be encountered by the plastic surgeon have been identified within this book. In each chapter, the authors attempt to synthesizethemyriad ofhistoricaldata and techniquesalongwith theirown personal experiencetoobtainthoseresultstoimprovethequalityoflifeand restoreanaesthetic appearance to the surgical area. Theapproach to each chapterfollows ourapproach to individual patients. This includesanassessmentofthedefect,indicationsfortheoperation,pathophysiologyof thechanges, operative techniques, and postoperativecare. It is our hope that this ap proach will mimic the approach we take daily in the preparation ofour patients. FinallyIwould like to thankmyassociates, MarkKobayashi, Michael Sundine, andJayCalvert,who havebeenan inspirationinmysurgicalskills. Iwouldalsoliketo thank the endless numberofstudentsand residents who continue to push our knowl edge and continue to drive us to perfection. I would be remiss ifI did not especially thank my lovingfamily, who haveprovided me withendlesssupport and understand ing in my professional life and mycommitment to patients and resident education. I trust that you willfind this workexcitingand will spureachofyou tostrivefor those more aestheticand quality-of-life issues we face daily. Gregory R. D. Evans iii CopyrightedMaterial CopyrightedMaterial Contents Preface iii Contributors IX CHEST 1. Anatomy of the Chest Wall William P. Adams, Jr. andJeffrey E. Janis 2. Preoperative Evaluation ofPatients Undergoing Chest Wall Reconstruction 17 Melissa A. Ka::.anolvski and GeofFey C Gurtner 3. Introduction to Surgical Infections of the Chest: Empyema and Mediastinitis 29 Blanding U Jones, Jeffrey Jim. and Jeffrey C Milliken 4. Treatment ofSternal Clefts 43 Michael 1. Sundine 5. Poland's Syndrome 63 Yvonne L. Karanas and James Chang 6. Pleural Defects 73 Jay W. Calvert 7. Alloplastic Reconstruction ofChest Wall Deformities 87 David1. Rowe awl Arun K Gosain 8. Reconstruction ofPectus Excavatum and Pectus Carinatum 99 Theodore S. Wright, Seema Kumbhat, and Michael L. Bent:! 9. Chest Wall Tumors 113 Mary Maish and Garrett Walsh v CopyrightedMaterial