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Chest wall resections, often performed for tumors, infections, or trauma, result in significant defects that require reconstruction to restore structural integrity and functionality. The use of twisted stainless steel wires (No. 05) for chest wall reconstruction offers a cost-effective and practical alternative. Steel wires provide robust structural support, allow dynamic movement of the chest wall during respiration, and are associated with improved postoperative pain control.
The chest wall, a complex dynamic structure composed of both rigid and soft tissues, plays a vital role in protecting thoracic organs and maintaining the mechanics of respiration. Reconstruction following chest wall resection is critical not only to achieve defect closure but also to preserve respiratory mechanics and minimize postoperative complications. The primary goals include providing structural support, ensuring stability, and achieving soft tissue coverage while maintaining chest wall flexibility and minimizing pain. Chest wall reconstruction using sternal steel wires enable better chest wall recoil, which is crucial for maintaining normal respiratory mechanics. Additionally, studies suggest that the use of steel wires reduces the incidence of chronic pain, as they do not involve direct exposure to synthetic materials that could irritate surrounding tissues or provoke inflammatory responses. The affordability and simplicity of steel wire-based reconstruction make it particularly suitable for underserved populations in Pakistan, where healthcare resources are limited, and the majority of patients cannot afford expensive surgical materials.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Wires Group | all the participants who undergo chest wall reconstruction using sternal steel wires, number 05 are included in this group. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Chest Wall Reconstruction | Procedure | there are many methods described in literature for reconstruction of chest wall after chest wall resection. The investigators are focusing on chest wall reconstruction using steel wires in this study. |
| Measure | Description | Time Frame |
|---|---|---|
| Chest Wall Recoil | Chest wall recoil after reconstruction is defined as maintenance of normal chest wall movement during respiration without paradoxical motion. It is assessed using spirometry (Forced Vital Capacity [FVC] and Forced Expiratory Volume in 1 second [FEV1]) compared with baseline/preoperative predicted values, radiological evaluation (postoperative chest X-rays for symmetrical expansion) and clinical observation (absence of paradoxical chest wall movement on examination). Preserving chest wall recoil is essential for normal breathing mechanics. Reconstruction with sternal steel wires aims to restore physiological elasticity, maintain ventilatory efficiency, and reduce respiratory complications. | 30 days post-operatively |
| Measure | Description | Time Frame |
|---|---|---|
| Post-Operative Pain Control | Post-operative pain control is measured using the Visual Analogue Scale (VAS) ranging from 0 (no pain) to 10 (worst imaginable pain). It is recorded at 24 hours, 72 hours, and 7 days postoperatively. Pain is a critical determinant of recovery, respiratory function, and overall patient satisfaction. Evaluating pain scores will help determine whether sternal steel wire fixation provides a less painful and more tolerable method of chest wall reconstruction compared to alternative techniques. |
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Inclusion Criteria:
Exclusion Criteria:
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All participants diagnosed with conditions requiring chest wall reconstruction and admitted to the thoracic surgery ward, emergency department, or outpatient department during the study period will be included in this study.
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| Name | Affiliation | Role |
|---|---|---|
| Muhammad Shoaib Nabi, Professor Of Thoracic Surgery | Services Institute Of Medical Sciences (SIMS), Services Hospital, Lahore | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Services Institute Of Medical Sciences (SIMS), Services Hospital, Lahore | Lahore | Punjab Province | Pakistan |
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| 24 hours, 72 hours and 07 days |