Maxfacts

Chest

Postoperative problems affecting the chest can be remedied as follows

• Non-surgical management of the chest, in terms of the lungs refers to chest infections, atelectasis (partial or complete collapse of the lung), pneumonia, these are all part of the potential generic postoperative problem scenario. Physiotherapy to promote coughing, adequate analgesia, mobilisation and targeted antibiotics / antibacterials are used.
• The chest, if seen as maxillofacial specific refers to the chest wall, which is primarily the donor site for flaps in reconstructive maxillofacial surgery. Pectoralis major is the main, thick superficial chest muscle. For purposes of maxillofacial reconstructive surgery, haematoma (accumulation of clotted blood in tissue) can occur underneath the remaining skin of the chest wall even though drains are always placed. Evacuation of haematoma is sometimes needed if a fresh bleed occurs or the drains are blocked. The scars can stretch and be unsightly and the female breast can be distorted. Conventional scar management is helpful. Some weakness in adduction (moving the arm inwards) of the arm will be noticed. Physiotherapy is the most useful approach.
• The pectoralis minor muscle is a small triangular muscle covered by the pectoralis major muscle. It serves as donor site for free flaps used in facial reanimation surgery. The donor site defects are minimal and the scar is on the side of the chest and doesn’t spread. Any postoperative problems are much minor versions of that with pectoralis major.