Omental transposition in the treatment of radionecrosis

A technique is described for the closure of chestwall defects following radical excision for radionecrosis. Such defects are usually extensive with an avascular bed and often involve an opening into the pleural cavity; surgical closure poses significant; problems. The method described here utilizes a transposed omental flap to provide a vascular bed for a skin‐graft, whilst cephalad shifting of the origin of the diaphragm is used to close the pleural defect. This latter innovation has the dual advantages of simplicity and effectiveness, whilst greatly facilitating the passage of the omentum to the chest wall with minimal risk of omental strangulation.