Thoracodorsal artery perforator (TAP) type I V-Y advancement flap in axillary hidradenitis suppurativa

Hidradenitis suppurativa is a chronic debilitating disease. Surgical removal of all apocrine glands in the affected region is the definitive treatment. The resulting wound may either be left to heal secondarily or closed primarily. Secondary healing in the axilla may cause contractures and stiffening of the shoulder. Primary healing requires direct closure, split-skin grafting or local flap application. Direct closure is associated with a high incidence of recurrence compared to skin grafting or flaps. Local flap cover is the ideal method of wound closure after excision of the glands. We have used a thoracodorsal artery perforator (TAP) V-Y advancement flap (type I) to achieve closure as a single-stage procedure successfully in four cases. It is a single stage procedure capable of closing large axillary defects whilst preserving the axillary contour.