Objective:

To address the challenges of reconstructing extensive full-thickness chest wall defects, particularly focusing on the complexities arising from radical resection of tumors or radiation-induced ulcers.

Key Findings:

• 38 patients had full-thickness defects; 28 received combined DIEP and TRAM flaps, highlighting the effectiveness of this approach.
• 97.7% successful defect resolution with mesh-reinforced rigid reconstruction, indicating a high success rate in restoring chest wall integrity.
• Postoperative complications managed conservatively; one mortality due to multi-organ failure, emphasizing the need for careful postoperative monitoring.

Interpretation:

The integrated DIEP-TRAM flap approach, combined with mesh-enhanced materials, effectively restores chest wall functionality and aesthetics in complex cases, contributing valuable insights to surgical practices.

Limitations:

• Retrospective design may introduce selection bias, limiting the ability to generalize findings.
• Limited generalizability due to single-center study, suggesting the need for multi-center trials.

Conclusion:

The study establishes an effective protocol for complex chest wall rehabilitation, emphasizing the importance of integrated surgical strategies and suggesting avenues for future research.