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  • Title: Perforator-based fasciocutaneous island flaps for the reconstruction of axillary defects following excision of hidradenitis suppurativa.
    Author: Geh JL, Niranjan NS.
    Journal: Br J Plast Surg; 2002 Mar; 55(2):124-8. PubMed ID: 11987945.
    Abstract:
    Hidradenitis suppurativa is a chronic socially debilitating disorder of unknown aetiology. Treatments include simple incision and drainage, excision and healing by secondary intention, spilt-skin grafting, and local-flap reconstructions. All of these methods can leave unsightly scars. Recurrence of the disease can be significantly reduced only by wide local excision of all the hair-bearing skin. Most methods involve repeated hospital admission, and leave contour defects in the upper arm and axilla. We describe a new method using double opposing V-Y perforator-based flaps to recreate the axillary contour after wide excision of the hair-bearing skin of the axilla. This method allows both axillae to be treated in a single stage, and represents a new alternative in the treatment of axillary hidradenitis suppurativa. Four patients are described: three underwent bilateral excision and reconstruction, while the fourth had a unilateral procedure. All patients had a single surgical procedure with no flap loss. The result following known reconstructive procedures is far from satisfactory: skin grafting leaves a divot deformity, and when a local flap, such as the posterior arm or thoracodorsal flap, is used it leaves a large bulky flap in the axilla. In our technique the flaps maintain the diamond shape of the axilla.
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