Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Radical Surgical Excision and Use of Lateral Thoracic Flap for Intractable Axillary Hidradenitis Suppurativa

  • Teo, Wan-Lin (Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital) ;
  • Ong, Yee-Siang (Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital) ;
  • Tan, Bien-Keem (Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital)
  • Received : 2012.05.20
  • Accepted : 2012.10.17
  • Published : 2012.11.15
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Abstract

Current treatments for hidradenitis suppurativa (HS) include prolonged courses of antibiotics, retinoids, immunosuppressants, and biologics. Severe cases that are resistant to prolonged medical treatment pose a therapeutic challenge. We propose radical excision and lateral thoracic flap reconstruction as a treatment option for such cases. In our experience with two patients, good aesthetic and functional outcomes were achieved, with a high level of patient satisfaction. The availability of suitable flap coverage allows for wide resection of all of the hair-bearing skin, leading to a low incidence of residual disease and subsequent recurrence. Following excision of the affected tissue, the ideal reconstructive method in the axilla provides suitable coverage without unacceptable donor site morbidity and also avoids axillary contractures. A long lateral thoracic flap with delay has excellent coverage with minimal donor tissue sacrifice. With a suitable flap coverage option, the management paradigm of intractable HS should shift from prolonged medical treatment to allow decisive radical excision, which will improve the quality of life for patients.

Keywords

References

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Cited by

  1. Medical and Surgical Treatment of Hidradenitis Suppurativa: A Review vol.3, pp.2, 2012, https://doi.org/10.1159/000462979
  2. MANAGEMENT OF AXILLARY DEFECT OF HIDRADENITIS SUPPURATIVA USING KEYSTONE DESIGN ISLANDED PERFORATOR FLAP- A SIMPLE AND DURABLE OPTION vol.7, pp.2, 2012, https://doi.org/10.14260/jemds/2018/49
  3. Treatment of Hidradenitis Suppurativa with Extensive Resection of the Lesion and Coverage with Perforator Flaps of the Lateral Thoracic Wall (Lateral Thoracic Artery, Thoracodorsal Artery Perforators) vol.7, pp.2, 2012, https://doi.org/10.1097/gox.0000000000002096
  4. Die Verwendung lokaler Perforatorlappenplastiken der Arteria thoracica lateralis (LTAP) und Arteria thoracodorsalis (TDAP) zur axillären Rekonstruktion bei Hidradenitis suppurativa vol.53, pp.4, 2012, https://doi.org/10.1055/a-1203-0322