Comparison of Mersilene Mesh–Methyl Metacrylate Sandwich and Polytetrafluoroethylene Grafts for Chest Wall Reconstruction

Abstract

We report the outcomes of patients who underwent reconstruction with Mersilene mesh–methyl methacrylate (MM–MM) sandwich and polytetrafluoroethylene (PTFE) grafts after a large chest wall resection. Between June 1990 and September 2001, 59 consecutive patients (37 men, 22 women; mean age, 48.1 ± 11.8 years; range 22–74 years) underwent large chest wall resection (greater than 5 cm diameter) and reconstruction with prosthetic material in our department. Twenty-one patients (33%) underwent reconstruction with a PTFE graft (group 2) between 1990 and 1994, and 38 patients (67%) underwent reconstruction with an MM–MM sandwich graft (group 1) between 1994 and 2001. Operative morbidity ratios were 5.2% (2/38) in group 1 and 24% (5/21) in group 2 (p =. 036). The paradoxical respiration ratio was significantly higher (p =. 018) in group 2 (5/21: 24%) than it was in group 1 (1/38: 2.6%). The operative mortality ratio was 4.5% (1/21) in group 2 and 0% in group 1. Mean hospital stay was 10.6 days (range 5–21 days) in group 1 and 13.3 days (range 7–36 days) in group 2 (p =. 015). The MM–MM graft is inexpensive and easy to apply, provides better cosmetic options, and offers minimal morbidity. We therefore recommend that the MM–MM sandwich graft be used rather than the PTFE graft for large defects of the anterolateral chest wall and sternum where successful prevention of paradoxical respiration is required.

KEYWORDS:

• chest wall resection
• chest wall reconstruction
• prosthetic material
• Mersilene mesh
• methyl methacrylate
• polytetrafluoroethylene