Free gracilis flap for chest wall reconstruction in male patient with Poland syndrome after implant failure

ABSTRACT

Poland’s syndrome (PS) is a congenital monolateral deformity that may involve breast, chest wall, and upper limb with different degrees of clinical expressions. In some cases, the problem is mainly cosmetic, and the reconstruction should be performed to achieve minimal scarring and donor site morbidity. The authors describe a case report of a male patient with PS who developed a severe capsular contraction after 25 years implant reconstruction, who was treated after explantation using free gracilis flap (FGF). In this patient, only the pectoralis major muscle was missing. An FGF was performed to reconstruct the anterior axillary fold and the soft tissue defect. There was no flap loss, the patient had a clearly improved appearance of the chest wall, and the pain syndrome was solved. In this case report, we demonstrate our experience with the use of an FGF for chest wall reconstruction in male patients with PS after prosthesis explantation.

KEY WORDS

Capsular contracture - chest wall deformity - gracilis free flap - Poland’s syndrome

• REFERENCES

• 1 Wechselberger G, Hladik M, Reichl H, Ensat F, Edelbauer M, Haug D. et al. The transverse musculocutaneous gracilis flap for chest wall reconstruction in male patients with Poland's syndrome. Microsurgery 2013; 33: 282-6
• 2 Poland A. Deficiency of the pectoral muscles. Guys Hosp Rep 1841; 6: 191-3
• 3 Fokin AA, Robicsek F. Poland's syndrome revisited. Ann Thorac Surg 2002; 74: 2218-25
• 4 Bavinck JN, Weaver DD. Subclavian artery supply disruption sequence: Hypothesis of a vascular etiology for Poland, Klippel-Feil, and Möbius anomalies. Am J Med Genet 1986; 23: 903-18
• 5 Pereira LH, Sabatovich O, Santana KP, Picanço R, Sterodimas A. Surgical correction of Poland's syndrome in males – A purposely designed implant. J Plast Reconstr Aesthet Surg 2008; 61: 393-9
• 6 Kelly EJ, O'Sullivan ST, Kay SP. Microneurovascular transfer of contralateral latissimus dorsi in Poland's syndrome. Br J Plast Surg 1999; 52: 503-4
• 7 Acarturk TO, Swartz WM, Luketich J, Quinlin RF, Edington H. Laparoscopically harvested omental flap for chest wall and intrathoracic reconstruction. Ann Plast Surg 2004; 53: 210-6
• 8 Gravvanis A, Lo S, Shirley R. Aesthetic restoration of Poland's syndrome in a male patient using free anterolateral thigh perforator flap as autologous filler. Microsurgery 2009; 29: 490-4
• 9 Pinsolle V, Chichery A, Grolleau JL, Chavoin JP. Autologous fat injection in Poland's syndrome. J Plast Reconstr Aesthet Surg 2008; 61: 784-91
• 10 Papadopoulos O, Konofaos P, Georgiou P, Chrisostomidis C, Tsantoulas Z, Karypidis D. et al. Gracilis myocutaneous flap: Evaluation of potential risk factors and long-term donor-site morbidity. Microsurgery 2011; 31: 448-53