Arch Plast Surg.  2017 May;44(3):228-233. 10.5999/aps.2017.44.3.228.

Axillary Reconstruction for Hidradenitis Suppurativa with an Inner-Arm Transposition Flap Creating a Brachioplasty Effect

• Ching DL
• Mughal M
• Papas A
• Soldin M

• KMID: 2403917
• DOI: http://doi.org/10.5999/aps.2017.44.3.228

Abstract

BACKGROUND
Hidradenitis suppurativa (HS) is a chronic skin condition that can affect any area with apocrine sweat glands and has the potential to involve multiple sites concurrently. Commonly affected sites include the axilla, groin, perineum and perianal areas. In this study we performed a literature review on the surgical methods for HS and describe an innovative technique for reconstructing axilla HS using an inner-arm transposition flap.
METHODS
We reviewed all cases (5 cases from 4 patients) of transposition flap reconstruction performed by the senior author at a single London tertiary hospital from 2008-2013. Patient related outcome measures were collected using the Derriford appearance scale (DAS 24) and a study specific questionnaire.
RESULTS
All patients were satisfied with their final result. One out of five cases had a complication but did not result in flap failure. There is no disease recurrence to date. DAS 24 scores collected demonstrated acceptable postoperative distress that did not deviate far from the norm tables while study specific questionnaire reveal desirable outcomes.
CONCLUSIONS
We have managed to achieve our aim through the use of the innovative inner-arm transposition flap. Our study hopes to provide an additional technique for axillary reconstruction. This technique offers the effective concealment of scars with the benefit of tightening of the arm tissue producing "˜brachioplasty like' effects. All things considered it would be reasonable to conclude the innovative flap technique is a reliable, effective, and simple method that results in multiple benefits.

Keyword

Hidradenitis suppurativa; Axilla; Surgical flap

MeSH Terms

Arm
Axilla
Cicatrix
Groin
Hidradenitis Suppurativa*
Hidradenitis*
Hope
Humans
Methods
Outcome Assessment (Health Care)
Perineum
Recurrence
Skin
Surgical Flaps
Sweat Glands
Tertiary Care Centers