ABSTRACT
I. INTRODUCTION The plastic surgeon may be called upon to evaluate chest wall deformities resulting from a spectrum of conditions. The underlying pathologic entities may include acquired deformities such as neoplasia, radionecrosis, infection. or trauma, as well as those with a congenital cause. Despite the breadth of causal factors responsible for the defects, there is a general consensus as to the overriding principles and surgical techniques employed in chest wall reconstruction. In many circumstances, the more critical question centers on the appropriateness of a surgical intervention in a given clinical circumstance. Guidelines for management of these often complex cases are poorly defined, with minimal supportive information in the literature because outcome data are generally lacking for chest wall reconstruction. An understanding of the overall outcome of a surgical approach in terms of survival, morbidity, and quality of life would seem to be important in order to evaluate fully the efficacy and benefit of operative intervention in these cases. This assessment would need not only to encompass the patient's medical condition and ability to withstand the procedure but also address the underlying cause of the defect as well as a number of critical pertinent variables.
