METHOD OF ELIMINATING A CHEST WALL DEFECT WITH A FULL-THICKNESS SKIN-SUBCUTANEOUS-FASCIO-MUSCULAR FLAP ON THE THORACOACROMIAL ARTERY Russian patent published in 2023 - IPC A61B17/00 

FIELD: medicine, abdominal surgery.

SUBSTANCE: invention can be used to treat perforations of the esophagus. A skin incision is made in the region of the anterior chest wall along 4–6 intercostal spaces, while the formed skin part must correspond to the shape of the defect. Next, the skin incision is extended cranially and laterally along the 3rd and 4th intercostal spaces and brought to the middle of the clavicle. The muscular part of the flap is formed, which contains the trunk of the thoracoacromial artery. This part of the pectoralis major muscle is cut off from the portion fixed to the humerus and from the portion fixed to the sternum and collarbone. In the caudal direction, a flap is formed so that in its distal part there is a full-layer skin-subcutaneous-fascio-muscular section of the flap, where the shape and size of the skin correspond to the shape and size of the chest wall defect. A tunnel is formed in the subcutaneous tissue, through which the formed flap is moved and placed in the defect of the chest wall. A perforated drainage is installed at the site of the flap sampling through a separate skin incision in the lower part of the wound. The wound is sutured. At the bottom of the chest wall defect, a perforated drain is placed, which is brought to the skin through a separate incision caudal to the lower edge of the wound. A full-thickness flap is adapted to the edges of the wound and sutured.

EFFECT: method makes it possible to eliminate the residual cavity in the region of the chest wall defect, promotes wound closure without tension on the skin edges, creates conditions for wound healing by primary intention with a good cosmetic effect.

1 cl, 2 ex