Figure 2.

(A) A 64-year-old man with recurrent squamous cell carcinoma of the chest wall previously treated with composite resection and pectoralis flap reconstruction with postoperative radiotherapy and chemotherapy. (B) Preoperative CT scan demonstrating involvement of the anterior and right chest wall. (C) Resection defect included the sternum, ribs 2 to 6, and the right upper lobe. (D) The defect was reconstructed with a composite polypropylene mesh/poly(methyl methacrylate) sandwich. (E) An ipsilateral pedicled latissimus dorsi muscle flap was harvested for soft tissue coverage and covered with a split-thickness skin graft from the thigh. (F) Appearance of chest wall reconstruction 2 months postoperatively. (Photographs courtesy of Donald P. Baumann, M.D.)