METHOD FOR TREATING PATIENTS WITH VAST DEFECTS OF ANTERIOR THORACIC WALL

FIELD: medicine, surgery. ^ SUBSTANCE: one should close vast defects of anterior thoracic wall; moreover, plasty should be carried out with deepidermalized skin-fascial fragments, at multiple control of tightening and circulation of fragments at their bottom. Spatial orientation of fragments should be determined due to spatial orientation of thoracic wall defect. Moreover, fragments may be counter bilateral thoracic formed in projection of great pectoral muscle, at bottom being at the edge of axillary fossa, or they may be counter thoracic and abdominal at its bottom in mesogastrium, along average clavicular line or at the middle between average clavicular and anterior axillary lines. True sizes of mobilized fragments should be determined after dissecting cicatricially altered tissues and removal of bony sequestra. One should fulfill pilot tamponade of wound defect with developed fragments, mark the border of deepidermalization and perform deepidermalization of fragment's free edge at the part which should tamponade the defect of thoracic wall. By defect's bottom one should apply the system of silicone tubes for aspiration through drainage, fulfill final tamponade of the present wound defect with deepidermalized skin-fascial fragments at fixation towards the bottom of the wound. Fragments should be additionally fixed together at final suturing at skin wound. The innovation enables to increase efficiency of reconstructive-restorative stage at vast defects of anterior thoracic wall. ^ EFFECT: higher efficiency of therapy. ^ 2 ex