Which of the following statements about chest wall resection and reconstruction is/are correct?

A. Most tumors of soft tissue and bone require 4-cm. margins to be adequately resected.

B. At least one normal rib above and below the primary tumor should be included in the resection.

C. Techniques of chest wall reconstruction are directed at the prevention of paradoxical chest wall movement with respiration

E. Chest wall defects that are covered by the scapula require no special reconstructive procedures, even if the defects are quite large.

DISCUSSION: Margins of resection of chest wall tumors should be at least 3 cm. of skin, 4 cm. of muscle, and 6 cm. of bone. Old biopsy sites should be included in the specimen. A normal rib above and below the specimen should also be included. Prevention of paradoxical chest wall movement is the primary goal of chest wall reconstruction. Large soft tissue defects are best managed by myocutaneous pedicle flaps. In general, defects larger than 5 cm. require reconstruction. Defects covered by the scapula require no reconstruction.