Reconstruction of axillary hidradenitis suppurativa defects with thoracodorsal artery perforator flaps: Our clinical experience

Abstract

Background: Axillary hidradenitis suppurativa (HS) is a chronic, debilitating condition. Sinus tracts, abscess foci, and relapsing chronic inflammation are the hallmarks of the disease, which affects about 1% of the population. Various treatment options have been used to counter the underlying inflammation, but their efficacy profile yields an unsatisfactory result. Aims and Objectives: Subpar treatment results guided us to a different treatment approach, putting surgical modalities as the hallmark of our approach. Surgical debridement of affected tissues often results in a defect, requiring a safe,effective reconstructive method. Results: Thoracodorsal artery perforator (TDAP) flap is a versatile flap which can be applied to reconstruct thoracic and axillary defects, whereas a free fasciocutaneous flap can be used as a reliable method to cover extensive defects located elsewhere in the body. In axillary HS, TDAP flap is a reliable method for reconstruction, providing adequate soft-tissue coverage, three-dimensional regular contours, and less adverse effects in the long term compared to skin grafts. Conclusion: In our article, we shared our experience with the usage of TDAP flap. Our results indicate that TDAP should be considered as a primary option in reconstruction of axillary HS defects.

Keywords

• axillary hidradenitis suppurativa
• perforator-based reconstruction
• thoracodorsal artery perforator flap