Reconstruction of the chest wall with a latissimus dorsi muscle flap after an infection of alloplastic material: a case report

Alloplastic material is often used for thoracic wall reconstruction following extended resection bringing the risk of infection, especially after chemotherapy and/or radiation. We present the case of a 66-year-old male with lung adenocarcinoma of the right lower lobe. After extended lobectomy, a partial resection of the sixth to eighth ribs followed by chest wall reconstruction with Mersilene mesh and osteosynthesis for sixth and seventh rib was performed. One month postoperatively, he developed pleural empyema. The alloplastic material was removed, extensive surgical debridement was performed and a latissimus dorsi muscle flap was used to cover the chest wall defect and fill out the remnant space supradiaphragmatically. Three years later, the patient has fully recovered with no local pain or relapse of the tumour. This case shows that rigid chest wall reconstruction with a soft autologous muscle flap is a valuable salvage option in case of infection, making alloplastic material highly risky.